介入治疗并发心脑梗死的疗效:一个病例系列和荟萃分析

H. Mohammed, E. Somaya
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引用次数: 0

摘要

背景:急性缺血性脑卒中和急性心肌梗死同时发生是一种极其罕见的可致死性急症。这些病例的病因、预后和最佳治疗方法尚不清楚。方法:通过文献复习和另外2例在Al-Shifa医院就诊的患者,分析其临床表现、危险因素、心肌梗死类型、脑卒中部位、改良分级量表及治疗方案。我们比较了联合介入治疗(冠状动脉经皮冠状动脉介入治疗和脑血管机械取栓)和在医院和中风后90天内接受药物治疗的患者的死亡率。结果:除了我们的病例外,我们从病例报告和系列中确定了94例并发心脑梗死,平均年龄为62.5±12.6岁。女性36例(38.3%),男性58例(61.7%)。只有21例(22.3%)接受了联合干预治疗。出院时死亡率为33.3%,90天死亡率为49.2%。联合干预治疗组患者住院死亡率为13.3%,90天死亡率为23.5%,与内科治疗组相比(住院死亡率为23.5%,90天死亡率为59.5%,p值分别为0.038和0.012)。结论:并发心脑梗死预后很差,约1 / 3患者在出院前死亡,一半患者在卒中后90天死亡。尽管只有四分之一的患者接受联合干预治疗,但与药物治疗相比,这种治疗方式大大降低了死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of intervention treatment for concurrent cardio-cerebral infarction: a case series and meta-analysis
Background: The concurrent occurrence of acute ischemic stroke and acute myocardial infarction is an extremely rare emergency condition that can be lethal. The causes, prognosis and optimal treatment in these cases are still unclear. Methods: We conducted the literature review and 2 additional cases at Al-Shifa Hospital, we analyzed clinical presentations, risk factors, type of myocardial infarction, site of stroke, modified ranking scale and treatment options. We compare the mortality rate among patients with combination intervention treatment (both percutaneous coronary intervention for coronary arteries and mechanical thrombectomy for cerebral vessels) and medical treatment at the hospital and 90 days after stroke. Results: In addition to our cases, we identified 94 cases of concurrent cardio-cerebral infarction from case reports and series with a mean age of 62.5 ± 12.6 years. Female 36 patients (38.3%), male 58 patients (61.7%). Only 21 (22.3%) were treated with combination intervention treatment. The mortality rate at hospital discharge was (33.3%) and the mortality rate at 90 days was (49.2%). In patients with the combination intervention treatment group: the hospital mortality rate was 13.3% and the 90-day mortality rate was: 23.5% compared with the mortality rate in medical treatment (23.5% at the hospital and 59.5% at 90 days (p value 0.038 and 0.012 respectively) Conclusion: Concurrent cardio-cerebral infarction prognosis is very poor, about a third of patients died before discharge and half of the patients died 90 days after stroke. Despite only one-quarter of patients being treated by combination intervention treatment, this treatment modality significantly reduces the mortality rate compared to medical treatment.
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