CTP 指导下急性缺血性脑卒中再灌注治疗的 Meta 分析。
CTP-guided reperfusion therapy in acute ischemic stroke: a meta-analysis.
机构信息
Neurovascular Imaging Laboratory, Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW, Australia.
University of New South Wales (UNSW, South Western Sydney Clinical School, Sydney, NSW, Australia.
出版信息
Acta Neurol Scand. 2021 Apr;143(4):355-366. doi: 10.1111/ane.13374. Epub 2020 Nov 27.
BACKGROUND
Computed tomography perfusion (CTP) imaging could be useful in guiding reperfusion therapy or patient selection in acute ischemic stroke (AIS) patients. The aim of the current study was to determine the efficacy of the CTP-guided reperfusion therapy in AIS by performing a systematic review and meta-analysis.
METHODS
Medline/PubMed, Embase, and the Cochrane library were searched using the terms: "CT perfusion", "acute stroke" and "reperfusion therapy". The following studies were included: (a) studies reporting original data; (b) patients aged 18 years or above; (c) patients diagnosed with anterior circulation AIS; and (d) studies with good methodological design.
RESULTS
Twenty-two studies were finally included in the metanalysis with a total of 5, 687 patients. CTP-guided reperfusion therapy was associated with increased odds of good functional outcome without significant difference in safety profile.
CONCLUSIONS
CTP-guided reperfusion therapy improved functional outcomes in AIS, with increased benefits to patients treated with endovascular thrombectomy.
背景
计算机断层灌注 (CTP) 成像可能有助于指导急性缺血性脑卒中 (AIS) 患者的再灌注治疗或患者选择。本研究的目的是通过系统评价和荟萃分析来确定 CTP 指导的再灌注治疗在 AIS 中的疗效。
方法
使用“CT 灌注”、“急性脑卒中”和“再灌注治疗”等术语在 Medline/PubMed、Embase 和 Cochrane 图书馆中进行搜索。纳入的研究如下：(a) 报告原始数据的研究；(b) 年龄在 18 岁或以上的患者；(c) 诊断为前循环 AIS 的患者；(d) 方法学设计良好的研究。
结果
最终有 22 项研究纳入荟萃分析，共纳入 5687 例患者。CTP 指导的再灌注治疗与良好的功能结局的可能性增加相关，且安全性方面无显著差异。
结论
CTP 指导的再灌注治疗可改善 AIS 的功能结局，血管内血栓切除术治疗的患者获益增加。
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