医学
改良兰金量表
溶栓
置信区间
优势比
耐受性
冲程(发动机)
临床终点
麻醉
随机对照试验
内科学
缺血性中风
心脏病学
缺血
不利影响
心肌梗塞
工程类
机械工程
作者
Jiaqi An,Yawen Cheng,Yichen Guo,Meng Wei,Minjie Gong,Yonglan Tang,Xingyun Yuan,Wenfeng Song,Chunying Mu,Aifeng Zhang,Ardan M. Saguner,Guoliang Li,Guogang Luo
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2020-10-08
卷期号:95 (24)
被引量:51
标识
DOI:10.1212/wnl.0000000000010884
摘要
Objective
To determine the effect of remote ischemic postconditioning (RIPC) on patients with acute ischemic stroke (AIS) undergoing IV thrombolysis (IVT). Methods
A single-center randomized controlled trial was performed with patients with AIS receiving IVT. Patients in the RIPC group were administered RIPC treatment (after IVT) during hospitalization. The primary endpoint was a score of 0 or 1 on the modified Rankin scale (mRS) at day 90. The safety, tolerability, and neuroprotection biomarkers associated with RIPC were also evaluated. Results
We collected data from both the RIPC group (n = 34) and the control group (n = 34). The average duration of hospitalization was 11.2 days. There was no significant difference between 2 groups at admission for the NIH Stroke Scale score (p = 0.364) or occur-to-treatment time (p = 0.889). Favorable recovery (mRS score 0–1) at 3 months was obtained in 71.9% of patients in the RIPC group vs 50.0% in the control group (adjusted odds ratio 9.85, 95% confidence interval 1.54–63.16; p = 0.016). We further found significantly lower plasma S100-β (p = 0.007) and higher vascular endothelial growth factor (p = 0.003) levels in the RIPC group than in the control group. Conclusions
Repeated RIPC combined with IVT can significantly facilitate recovery of nerve function and improve clinical prognosis of patients with AIS. ClinicalTrials.gov identifier
NCT03218293. Classification of evidence
This study provides Class IV evidence that RIPC after tissue plasminogen activator treatment of AIS significantly increases the proportion of patients with an MRS score of 0 or 1 at 90 days.
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