Jiang Shenglei, Zhou Yitao, Zhou Yangbin, Huang Ganying
Department of Emergency, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang Province, China.
School of nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
BMC Neurol. 2024 Dec 3;24(1):469. doi: 10.1186/s12883-024-03976-7.
This meta-analysis aimed to determine the potential benefits of intensive blood pressure management in ischemic stroke patients who have undergone endovascular thrombectomy (EVT).
We comprehensively searched all relevant studies published before August 23, 2024, using multiple databases, including Cochrane Library, Embase, PubMed, Web of Science and China National Knowledge Infrastructure (CNKI) and Wangfang. The primary outcomes were favorable outcomes at 90 days (mRS score = 0-2), while the secondary outcomes comprised 90-day mortality, incidence of symptomatic intracranial hemorrhage (sICH), and 7-day mortality.
Six randomized controlled trials studies involving 1752 patients were included. The incidence of 90 days (mRS score = 0-2) score was significant difference between different blood pressure management (RR = 0.81, 95% CI [0.74, 0.89], p < 0.01) with heterogeneity (I = 0%, p = 0.52). No significant difference was perceived in the 90-day mortality (RR = 1.16, 95% CI [0.90, 1.48], p = 0.28; I 0%, p = 0.89). Additionally, there was no statistically significant difference in the incidence of sICH, (RR = 1.03, 95% CI [0.72, 1.48], p = 0.86; I 0%, p = 0.42). There was also no statistically significant discerned in the 7-day mortality (RR = 1.33, 95% CI [0.88, 2.01], p = 0.17; I 0%, p = 0.67).
Our research results suggest that routine standard blood pressure management is more beneficial to the functional independence for patients, a more moderate intensive blood pressure management should be used.
本荟萃分析旨在确定强化血压管理对接受血管内血栓切除术（EVT）的缺血性中风患者的潜在益处。
我们使用多个数据库全面检索了2024年8月23日之前发表的所有相关研究，包括Cochrane图书馆、Embase、PubMed、科学网和中国知网（CNKI）以及万方。主要结局为90天时的良好结局（改良Rankin量表评分=0-2），次要结局包括90天死亡率、症状性颅内出血（sICH）发生率和7天死亡率。
纳入了6项涉及1752例患者的随机对照试验研究。不同血压管理之间90天（改良Rankin量表评分=0-2）评分的发生率存在显著差异（风险比=0.81，95%置信区间[0.74，0.89]，p<0.01），异质性为（I=0%，p=0.52）。90天死亡率无显著差异（风险比=1.16，95%置信区间[0.90，1.48]，p=0.28；I=0%，p=0.89）。此外，sICH发生率无统计学显著差异（风险比=1.03，95%置信区间[0.72，1.48]，p=0.86；I=0%，p=0.42）。7天死亡率也无统计学显著差异（风险比=1.33，95%置信区间[0.88，2.01]，p=0.17；I=0%，p=0.67）。
我们的研究结果表明，常规标准血压管理对患者的功能独立性更有益，应采用更适度的强化血压管理。
