Neurology:卒中患者合并肾功能不全,强化降压治疗可能适得其反!(ATACH-2研究)

2021-07-26 MedSci原创 MedSci原创

卒中和慢性肾病都是相当棘手的疾病,当同时患有这两类疾病时,治疗上更是难上加难。

卒中和慢性肾病都是相当棘手的疾病,当同时患有这两类疾病时,治疗上更是难上加难。 肾功能损害对脑出血 (ICH) 的临床影响尚不清楚。 本研究旨在探索性评估估计的肾小球滤过率 (eGFR) 是否影响临床结果或改变强化收缩压 (BP) 控制(目标,110-139 mmHg)相对于标准(目标,140-179 mmHg)的功效 在 ICH 患者中。 日本国家心脑血管中心发表在《Neurology》杂志上的一项最新研究提示,对于肾功能不全的急性脑出血患者, 强化降压(收缩压110-139 mmHg) 可能会导致更为严重的后果。 该研究对 ATACH-2(一项随机、两组、开放标签试验)进行了事后分析。 每个符合条件的患者的基线 eGFR 使用慢性肾脏病流行病学合作方程计算。 感兴趣的结果是在 90 天时死亡或残疾。 在随机分配的 1000 名患者中,分析了 974 名。 中位基线 eGFR 为 88(四分位距:68, 99)ml/min/1.73 m2; 451 (46.3%)、363 (37.3%) 和 160 (16.4%) 名患者的基线 eGFR 值分别≥90、60–89 和 <60

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    2021-10-25 zhouqu_8
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    2021-12-20 grace5700
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time=2021-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419116, encodeId=60661419116e0, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Wed Jul 28 00:08:52 CST 2021, time=2021-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466116, encodeId=2d551466116e1, content=<a href='/topic/show?id=217c292009' target=_blank style='color:#2F92EE;'>#ATA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2920, encryptionId=217c292009, topicName=ATA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387a6772119, createdName=bbjsj_1981, createdTime=Wed Jul 28 00:08:52 CST 2021, time=2021-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026922, encodeId=0d7e1026922f9, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Mon Jul 26 12:08:52 CST 2021, time=2021-07-26, status=1, ipAttribution=)]
    2021-10-31 yese
  5. 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  6. 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  7. 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    2021-07-28 bbjsj_1981
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    2021-07-26 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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Stroke:卒中和痴呆的长期发病率

与基于阿替洛尔的降压方案相比,基于氨氯地平的降压方案降低了卒中的长期发病率,但对痴呆症没有可显著的影响。阿托伐他汀对卒中或痴呆症均无效应。较高的血压变异性与较高的后期痴呆和卒中发生率相关。

Neurology:卒中患者合并肾功能不全,强化降压治疗可能适得其反!

卒中和慢性肾病都是相当棘手的疾病,当同时患有这两类疾病时,治疗上更是难上加难。

梅斯心血管疾病进展 (009期)

编者按:梅斯医学将定期进行汇总,帮助大家概览心血管领域最新进展。下面是呈现给大家的最新一期的心血管进展。enjoy~

JAHA:左房应变可预测窦性心律的急性心衰患者卒中风险

在伴有窦性心律的急性HF患者中,LAGLS降低(<14.5%)与卒中风险增加相关,其年发病率为2.38%。

Stroke:接受选择性血清素再摄取抑制剂治疗的卒中患者骨折风险如何?

根据氟西汀和西酞普兰的现有RCT,使用6个月的SSRI使卒中幸存者的骨折风险增加了一倍。