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【medical-news】Early coronary revascularization after MI c
心梗后的早期再灌注可以降低脑中风风险性
NEW YORK (Reuters Health), Oct 24 - The faster that thrombolytic therapy or angioplasty can be applied after a myocardial infarction (MI), the lower the chances that the patient will also experience a stroke, new research suggests.
纽约（路透社）10月24日——心肌梗死后溶栓治疗或者血管成形术进行的越早，病人继发脑梗死的概率也就越低，这是最新的研究结果。
Recent reports suggest that less than 1% of MIs are complicated by stroke, but the combined occurrence of these events can have devastating consequences. The timing and type of coronary revascularization may play a role in the stroke risk, but until now no studies have looked at this.
最近的研究提示不到1%的心肌梗塞伴发脑梗死，但是如果两者共同发生，后果十分严重。心肌梗死以后血管再通的时间和方式对脑中风的危险性具有一定影响。直到最近还没有研究关注这一方面。
The present study, reported in the October issue of Stroke, involved more than 90,000 patients who were entered in a national MI registry. About half of the patients were treated with thrombolytic therapy and half underwent angioplasty.
本研究发表《中风》第十期上，包括全国注册的9万例病人。约有半数的病人行溶栓治疗，半数病人行血管成形术。
The in-hospital stroke rates in the thrombolytic and angioplasty groups were 0.54% and 0.31%, respectively, lead author Dr. Steven R. Steinhubl, from the University of Kentucky in Lexington, and colleagues note.
Lexington的Kentucky大学Steven博士是本文的第一作者，他注意到溶栓治疗和血管成形术在住院期间发生脑梗死的概率分别为0.54%和0.31%.
As the time to revascularization therapy increased, the stroke risk also rose, the report indicates.
该研究报告称随着血管再灌注时间的延长，脑中风的危险性也增加。
On multivariate analysis, which took into account 26 relevant variables, delivery of thrombolytic therapy within 15 minutes of ER arrival cut the risk of stroke by 42% compared with longer treatment delays. Similarly, use of angioplasty within 90 minutes of arrival also seemed to reduce the stroke risk, although the association fell short of statistical significance.
在多元回归分析中，考虑到26种变量以后，到达急诊后的15分钟内进行溶栓治疗，与更长的治疗时间相比，可以把脑中风的风险降低42%.于此相似，到达急诊的90分钟内，进行血管成形术，也可以降低脑中风的风险性，但是没有达到统计学上的显著性。
The authors found, somewhat unexpectedly, that the benefits of early reperfusion therapy did not seem to relate to improvements in left ventricular function.
作者注意到，有一点发现出乎意料，早期灌注与心室功能的提高没有关系。
In a related editorial, Dr. Jose I. Suarez, from Case Western Reserve University in Cleveland, speculates on why early reperfusion might decrease the stroke risk. He comments that it may relate to earlier use of beta-blockers, leading to a drop in sympathetic activity and inflammation. He calls for further studies to elucidate the mechanisms involved.
Cleveland的Case Westen Reserve Jose教授在一篇论述中，推测了为什么早期灌注能够降低脑中风的危险性。他认为这与早期应用贝塔受体阻滞剂有关，可以降低交感神经兴奋性和炎症。他呼吁进行进一步的研究来解释相关的机制。
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作者:admin@医学,生命科学 2010-11-18 05:11
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