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931.
ObjectiveTo test the feasibility and efficacy of multimodality stimulation combined with motor tasking as a corrective strategy for hemineglect following right hemispheric ischemic strokes.Material and methodsA prospective randomized controlled single blinded clinical trial was conducted over eighteen months from January 2017. All patients with right hemispheric ischemic strokes were screened for hemineglect and those fulfilling criteria were recruited and randomized. Patients under the therapy group (TG) received the intervention based on a structured protocol in addition to standard physiotherapy. The control group (CG) received standard physiotherapy alone. NIHSS, mRS and Neuropsychological test scores were recorded at different time points. The primary outcome measures (neuropsychological test scores) were compared between the two groups (Student's t-test to find out the difference in outcome measures) at one and three months post-stroke.ResultsOf the 14 patients recruited, data from 12 were available for analysis, 5 patients in TG and 7 in CG. There was a trend for better hemineglect and functional outcomes in TG.ConclusionMultimodality stimulation, in addition to standard physiotherapy, is feasible and potentially results in better neurocognitive and functional recovery following right hemispheric ischemic strokes. However, larger studies are warranted to prove these preliminary observations beyond doubt. 相似文献
932.
Changhong Ren Ning Li Chen Gao Wei Zhang Yong Yang Sijie Li 《Neurological research》2020,42(8):683-692
ABSTRACT
Objectives
Following stroke, angiogenic strategy has been proposed to alleviate ischemia-induced injury by promoting angiogenesis and improving cerebrovascular function in the ischemic regions. Ligustilide (LGSL) is known to have neuroprotection against ischemic stroke-induced injury. But the effect of LGSL on promoting angiogenesis after ischemic stroke is unknown. The purpose of this study was to determine the effects of LGSL on neuroprotection and angiogenesis after stroke. 相似文献933.
目的 分析河北省南和县农村卒中患者应用二级预防抗血小板药物、他汀类药物和降压药物的服
药依从性现状,并探讨其影响因素。
方法 本研究使用群组随机对照试验“南和县实用创新型脑卒中防治项目”的基线调查数据。该横
断面调查于2017年7月抽取位于5个镇的50个村,每村抽取符合纳入和排除标准的卒中患者开展问卷
调查及体格检查。问卷主要信息包括:社会人口学信息、患病史、社会支持、服药依从性等。患者服
药依从性根据Morisky Green Levine量表评测。采用多因素Logistic回归分析法分析患者抗血小板药物、
他汀类药物和降压药物服药依从性的影响因素。
结果 共纳入1299例卒中患者,平均年龄65.7±8.2岁,男性746例(57.4%)。服用抗血小板类、他汀
类、降压药物的患者分别占依照诊断史估测应服药人数的72.0%(852/1184)、28.4%(340/1197)和
91.1%(1030/1131)。服药患者中,药物依从率分别为63.0%(537/852)、63.5%(216/340)和62.6%
(645/1030)。多因素分析显示,自我感知照护需求低的患者(OR 0.58,95%CI 0.45~0.75,P<0.001),
服用抗血小板药物依从性好;有卒中复发史患者(OR 2.09,95%CI 1.17~3.71,P =0.013)服用他汀类
药物依从性差,无吸烟史患者(OR 0.43,95%CI 0.19~0.97,P =0.043)服用他汀类药物依从性好。
年龄较大(OR 0.97,95%CI 0.95~0.99,P =0.004)、服2种以上药物(OR 0.54,95%CI 0.39~0.75,
P <0.001)、自我感知照护需求低(OR 0.58,95%C I 0.40~0.84,P =0.004)及无吸烟史患者
(OR 0.63,95%CI 0.41~0.84,P =0.046)服用降压类药物依从性好。
结论 河北省南和县农村卒中患者二级预防合理用药率较低,服药患者依从性不佳,服药依从性
与患者年龄、吸烟史、卒中复发史、服药数量、自我感知照护需求等因素相关。 相似文献
934.
Alleviating myocardial injury associated with ST elevation myocardial infarction is central to improving the global burden of coronary heart disease. The chemokine stromal cell-derived factor 1α (SDF-1α) has dual potential benefit in this regard. Firstly, SDF-1α is up-regulated in experimental and clinical studies of acute myocardial infarction (AMI) and regulates stem cell migration to sites of injury. SDF-1α delivery to the myocardium after AMI is associated with improved stem cell homing, angiogenesis, and left ventricular function in animal models, and improvements in heart failure and quality of life in humans. Secondly, SDF-1α may have a role in remote ischaemic conditioning (RIC), the phenomenon whereby non-lethal ischaemia–reperfusion applied to an organ or tissue remote from the heart protects the myocardium from lethal ischaemia–reperfusion injury (IRI). SDF-1α is increased in the serum of rats subjected to RIC and protects against myocardial IRI in ex vivo studies. Despite these potential pleiotropic effects, a limitation of SDF-1α is its short plasma half-life due to cleavage by dipeptidyl peptidase-4 (DPP-4). However, DPP-4 inhibitors increase the half-life of SDF-1α by preventing its degradation and are also protective against lethal IRI. In summary, SDF-1 potentially delivers a ‘two-pronged’ defence of the myocardium: acutely protecting it from IRI while simultaneously stimulating repair by recruiting stem cells to the site of injury. In this article we examine the evidence for acute and chronic cardioprotective roles of SDF-1α and discuss potential therapeutic manipulations of this mechanism with DPP-4 inhibitors to protect against lethal tissue injury in the clinical setting. 相似文献
935.
杜杰 《中国实用神经疾病杂志》2015,(1)
目的探讨大剂量辛伐他汀强化治疗对缺血性脑血管患者脑血管储备能力的影响及安全性。方法将108例缺血性脑血管病患者随机分成观察组与对照组各54例,2组均在常规治疗的基础上口服辛伐他汀,观察组40mg/次,对照组20mg/d,2组均1次/d,疗程均为6个月。比较2组患者临床疗效、脑血管储备功能(CVR)及屏气指数(BHI)、药物不良反应、复发率及病死率。结果观察组CVR(35.19±5.24)、BHI(1.54±0.33)明显高于对照组;不良反应发生率为(31.48%)、复发率、病死率(5.77%、3.85%)明显低于对照组(P0.05、0.01)。结论大剂量辛伐他汀强化治疗能有效改善脑血管储备能力,降低复发率及病死率,但需严密监测药物不良反应。 相似文献
936.
Eyad Almallouhi Sami Al Kasab Jillian B. Harvey Christopher Reardon Ali Alawieh Tarun Girotra Patricia Aysse Raymond D. Turner Christine A. Holmstedt 《Journal of stroke and cerebrovascular diseases》2019,28(1):185-190
Objective
To assess the long-term functional outcome of stroke in patients treated with mechanical thrombectomy (MT) performed during work hours (on-hours) versus after-hours, weekends, and official holidays (off-hours).Methods
Data on all patients receiving MT at a comprehensive stroke center was collected between December 2014-December 2016. Our primary outcomes were the discharge and 90-day modified Rankin Scale (mRS). We developed propensity scores for off-hours treatment and used inverse probability of treatment weights to address confounding. We estimated logistic regression to assess the relationship between off-hours treatment and favorable patient outcomes. Independent variables include receiving thrombectomy during the off-hours, admission National Institute of Health Stroke Scale (NIHSS), door to groin time in minutes, age, and race.Results
During the study period, 80 (41%) patients underwent thrombectomy during on-hours and 116 (59%) during off-hours. Mean age was 69.1 years for the on-hours group and 64.1 years for the off-hours group (P?=?.02). There were no statistically significant differences in median admission NIHSS, rate of alteplase administration, mean time from last known well to thrombectomy, rate of revascularization, and rate of hemorrhagic transformation between the 2 groups. Logistic regression analysis showed the probability of a favorable outcome at discharge (mRS ≤ 2) is 12.6 % lower for off-hours patients (P?=?.038, [95%CI ?.25 to ?.01]). For patients with a 90-day mRS (n?=?117), the probability of a favorable outcome was 18.7% lower for those treated during the off-hours (P?=?.029, [95%CI ?.36 to ?.02]).Conclusions
There is a higher probability of a good functional outcome in acute ischemic stroke patients who receive MT when performed during regular work hours. 相似文献937.
目的对阿托伐他汀治疗稳定型冠心病的临床效果进行分析。方法120例稳定型冠心病患者,随机分为对照组和观察组,每组60例。对照组患者采用常规治疗,观察组患者在对照组基础上联合阿托伐他汀治疗。比较两组患者治疗前后血脂指标水平、缺血事件发生情况。结果治疗前,两组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较差异无统计学意义(P>0.05);治疗后,观察组患者TC(4.27±0.42)mmol/L、TG(2.14±0.59)mmol/L、LDL-C(0.93±0.52)mmol/L均低于对照组的(5.43±0.94)、(2.44±0.71)、(3.27±0.34)mmol/L,HDL-C(1.44±0.54)mmol/L高于对照组的(1.24±0.44)mmol/L,差异具有统计学意义(P<0.05)。观察组患者缺血事件发生率为5.0%,低于对照组的16.7%,差异具有统计学意义(P<0.05)。结论采用阿托伐他汀治疗稳定型冠心病有助于改善患者血脂指标,降低缺血事件发生率,为稳定型冠心病的临床治疗提供了参考依据。 相似文献
938.
939.
Efaza U. Siddiqui Timothy P. Murphy Syed S. Naeem Ayesha Siddique Gregory E. McEnteggart Roberto Scarpioni 《Journal of vascular and interventional radiology : JVIR》2018,29(7):966-970
Purpose
To perform a post-hoc analysis of the Nephropathy Ischemic Therapy (NITER) trial, which enrolled patients with atherosclerotic renal artery stenosis, to evaluate whether medical therapy plus stent placement is superior to medical therapy alone in patients without elevated albuminuria.Materials and Methods
Data from 51 patients were analyzed and stratified into 2 cohorts by median urinary albumin (UAlb) levels: cohort 1 (“low albuminuria,” UAlb ≤0.04 g/24h) and cohort 2 (“high albuminuria,” UAlb >0.04g/24h). Interaction effect between treatment arms and UAlb cohorts was calculated using Cox regression analysis. Survival analysis was followed by test for effect size, power analysis, and construction of a Kaplan-Meier survival table.Results
At study completion, 13 patients had an outcome event: 6 (23%) from cohort 1 and 7 (28%) from cohort 2. Patients in cohort 1 had event-free survival of 83% at 3.9 ± 0.3 years from the primary endpoints of all-cause mortality, dialysis, and cardiovascular events when treated with interventional therapy, compared to 45% when treated with medical therapy alone (P = .501), which showed a 62% treatment effect for stent placement. In cohort 2, event-free survival rates were 64% for medical therapy versus 52% for medical plus interventional therapy (P = .64). Using Cox regression analysis, the interaction effect between treatment arms and UAlb cohorts was not significant (P = .32). The power of the study to detect an interaction effect, if one existed, was only 15%.Conclusions
Inference cannot be drawn for similar populations because of inadequate sample size, but, in this sample, patients treated with stent placement who had low albuminuria had better outcomes than patients treated with medical therapy alone. 相似文献940.
缺血性心脏病(IHD)不同阶段的病理组织学改变与病人预后和生活质量密切相关。心血管MR(CMR)成像技术具有多参数、多成像序列,能对IHD进行早期诊断,评价微血管阻塞、心肌内出血、瘢痕心肌和舒张末期心室壁厚度,通过对急慢性心肌梗死进行早期诊断和远期风险评估,为病人的早期治疗及降低预后风险提供信息。就CMR在急慢性IHD心肌组织特征、风险评估和病人远期预后方面的应用予以综述。 相似文献