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急性缺血性卒中/短暂性脑缺血发作患者先前使用抗血小板药物治疗与预后无关。

Prior therapy with antiplatelet agents is not associated with outcome in patients with acute ischemic stroke/TIA.

作者信息

Greisenegger S, Tentschert S, Weber M, Ferrari J, Lang W, Lalouschek W

机构信息

Department of Neurology Medical, University of Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.

出版信息

J Neurol. 2006 May;253(5):648-52. doi: 10.1007/s00415-006-0088-0. Epub 2006 Apr 20.

Abstract

BACKGROUND AND PURPOSE

It is unclear whether prior therapy with antiplatelet agents (APA) is associated with a better outcome in patients with acute ischemic cerebrovascular events.

METHODS

Within a multi-center cross-sectional study, nested in a cohort we analyzed the relation between prior therapy with APA and stroke severity in 1643 patients with acute ischemic stroke or TIA. Clinical severity of the vascular event was evaluated by the National Institutes of Health Stroke Scale on admission (NIHSS1) and after 1 week (NIHSS2). By means of analysis of variance we analyzed a possible association of APA with stroke severity and interactions regarding stroke severity between APA and other clinical measures.

RESULTS

475 patients (29 %) received aspirin prior to the cerebrovascular event, 51 patients (3 %) ticlopidine or clopidogrel and 26 patients (1.6%) aspirin combined with extended release dipyridamole. 66% (1091) of patients did not take any antiplatelet medication. Neither the NIHSS1 nor the NIHSS2 nor the change of stroke severity between these time points (NIHSS1- NIHSS2) was associated with prior APA medication. We did not find significant interactions between APA use and clinical measures regarding stroke severity.

CONCLUSIONS

Our results do not indicate that prior therapy with APA is associated with a better outcome in acute ischemic cerebrovascular events. There were no interactions found with other features that were associated with stroke severity.

摘要

背景与目的

对于急性缺血性脑血管事件患者,先前使用抗血小板药物(APA)治疗是否与更好的预后相关尚不清楚。

方法

在一项多中心横断面研究中,我们在一个队列中分析了1643例急性缺血性中风或短暂性脑缺血发作(TIA)患者先前使用APA治疗与中风严重程度之间的关系。血管事件的临床严重程度通过入院时(NIHSS1)和1周后(NIHSS2)的美国国立卫生研究院卒中量表进行评估。通过方差分析,我们分析了APA与中风严重程度之间可能的关联以及APA与其他临床指标之间关于中风严重程度的相互作用。

结果

475例患者(29%)在脑血管事件发生前服用了阿司匹林,51例患者(3%)服用了噻氯匹定或氯吡格雷,26例患者(1.6%)服用了阿司匹林联合缓释双嘧达莫。66%(1091例)的患者未服用任何抗血小板药物。NIHSS1、NIHSS2以及这些时间点之间中风严重程度的变化(NIHSS1 - NIHSS2)均与先前的APA用药无关。我们未发现APA使用与中风严重程度的临床指标之间存在显著的相互作用。

结论

我们的结果并未表明先前使用APA治疗与急性缺血性脑血管事件的更好预后相关。未发现与中风严重程度相关的其他特征之间存在相互作用。

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