Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
BMJ Open. 2013 Jun 20;3(6):e002932. doi: 10.1136/bmjopen-2013-002932.
External counterpulsation (ECP) is a non-invasive method being investigated for ischaemic stroke. We aimed to explore predictors of good functional outcome for ECP-treated ischaemic stroke patients who completed a minimum of 10 sessions.
We analysed our ECP registry of ischaemic stroke patients with cerebral large artery stenosis who underwent ECP therapy at the Prince of Wales Hospital from 2004 to 2010. We included 155 patients who completed at least 10 sessions of ECP and had 3-month follow-up data as well as 52 medical controls. Functional outcomes were dichotomised into good outcome (modified Rankin Scale (mRS) 0-2) and bad outcome (mRS 3-6). We compared the differences in two groups in terms of demographics, medical history and parameters of ECP treatment.
At 3 months after stroke, 70.5% of patients who finished the whole course of ECP had a good outcome (only 46.5% in the unfinished group and 38.5% in the medical group). Among all 207 recruited cases, 119 (57.5%) patients had a good outcome at 3 months after stroke. Compared with the bad outcome group, patients in the good outcome group were younger and had a lower baseline National Institutes of Health Stroke Scale (NIHSS) and longer ECP therapy duration. Multivariate logistic regression showed that ECP duration (OR 1.032), baseline NIHSS (OR 0.734) and age (OR 0.961) were independent predictors for a favourable outcome.
Duration of ECP therapy is first found to be an important predictor for good outcome of ECP-treated ischaemic stroke patients, in addition to the well-known prognostic factors such as age and NIHSS.
体外反搏（ECP）是一种针对缺血性中风的非侵入性治疗方法。我们旨在探讨接受至少 10 次 ECP 治疗且完成治疗的缺血性中风患者的良好功能结局的预测因素。
我们分析了我们的 ECP 登记处中患有大脑大动脉狭窄的缺血性中风患者，这些患者在 2004 年至 2010 年期间在威尔斯亲王医院接受了 ECP 治疗。我们纳入了 155 名完成至少 10 次 ECP 治疗且有 3 个月随访数据的患者，以及 52 名医学对照组患者。功能结局被分为良好结局（改良 Rankin 量表（mRS）0-2）和不良结局（mRS 3-6）。我们比较了两组在人口统计学、病史和 ECP 治疗参数方面的差异。
在中风后 3 个月，完成整个 ECP 疗程的患者中有 70.5%（未完成疗程的患者为 46.5%，医学对照组为 38.5%）有良好结局。在所有 207 例招募病例中，119 例（57.5%）患者在中风后 3 个月有良好结局。与不良结局组相比，良好结局组的患者年龄较小，基线国立卫生研究院中风量表（NIHSS）评分较低，ECP 治疗时间较长。多变量逻辑回归显示，ECP 治疗时间（OR 1.032）、基线 NIHSS（OR 0.734）和年龄（OR 0.961）是良好结局的独立预测因素。
除了年龄和 NIHSS 等众所周知的预后因素外，ECP 治疗时间首次被发现是接受 ECP 治疗的缺血性中风患者良好结局的重要预测因素。
