Huang Zhi-Xin, Lin Jianguo, Zhang Cheng, Dai Ying-Yi, Lin Songbin, Liu Xintong
Department of Neurology, Guangdong Second Provincial General Hospital, Southern Medical University, Guangzhou 510317, China.
Department of Neurology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510317, China.
Evid Based Complement Alternat Med. 2020 Sep 9;2020:6912015. doi: 10.1155/2020/6912015. eCollection 2020.
Early neurologic deterioration (END) in the acute phase of ischemic stroke is a serious clinical event, which is closely related to poor prognosis. Therefore, it is important to identify presentation features that predict END and take relevant treatment measures, as they could help to prevent the deterioration of high-risk patients. The prospective intervention study was carried out from January 2018 to December 2019. We included consecutive patients hospitalized for acute ischemic stroke (AIS) within 6 hours of onset. Patients were randomly assigned (1 : 1) to recanalization therapy plus Huoxiang Zhengqi Pill (HXZQ) (intervention group) or standard recanalization therapy alone (control group). The primary outcome was the development of END according to predefined criteria within the first 1 week of stroke onset. Poisson regression was used to identify predictors for END. Of the 155 patients enrolled in the study (age, 63 ± 11 years; 28.4% female), 20 (12.9%) developed END. Univariate analysis showed that the use of HXZQ and Essen stroke risk score (ESRS) (low risk group) were protective factors for END, while advanced age was a risk factor for END. However, in multivariate analysis, only ESRS (OR, 0.232; 95%CI, 0.058-0.928; =0.039) and the use of HXZQ (OR, 0.297; 95%CI, 0.096-0.917; =0.035) were statistically significant. ESRS can be used as the prediction factor of END. HXZQ has small side effects and wide indication. It could be used in the treatment of AIS.
缺血性中风急性期的早期神经功能恶化（END）是一种严重的临床事件，与预后不良密切相关。因此，识别预测END的表现特征并采取相关治疗措施很重要，因为它们有助于预防高危患者的病情恶化。前瞻性干预研究于2018年1月至2019年12月进行。我们纳入了发病6小时内因急性缺血性中风（AIS）住院的连续患者。患者被随机分配（1∶1）至再通治疗加藿香正气丸（HXZQ）组（干预组）或单纯标准再通治疗组（对照组）。主要结局是根据中风发作后第1周内的预定义标准发生END。采用泊松回归识别END的预测因素。在纳入研究的155例患者中（年龄63±11岁；女性占28.4%），20例（12.9%）发生END。单因素分析显示，使用HXZQ和Essen中风风险评分（ESRS）（低风险组）是END的保护因素，而高龄是END的风险因素。然而，多因素分析显示，只有ESRS（OR，0.232；95%CI，0.058 - 0.928；P = 0.039）和使用HXZQ（OR，0.297；95%CI，0.096 - 0.917；P = 0.035）具有统计学意义。ESRS可作为END的预测因素。HXZQ副作用小、适应证广。它可用于AIS的治疗。
