目的 綜合分析與腦卒中有關(guān)的降壓治療大樣本隨機(jī)對(duì)照試驗(yàn),為腦卒中二級(jí)預(yù)防提供臨床證據(jù).
方法 計(jì)算機(jī)檢索Medline(1966～2003年6月),對(duì)已公開發(fā)表的大樣本隨機(jī)對(duì)照降壓治療預(yù)防腦卒中再發(fā)的臨床試驗(yàn)進(jìn)行綜合分析.分析指標(biāo)為腦卒中事件、冠心病事件及總死亡率等.
結(jié)果 共納入腦卒中后抗高血壓治療的隨機(jī)對(duì)照試驗(yàn)(PATS)、多中心培哚普利降壓治療腦卒中/一過性腦缺血發(fā)作的隨機(jī)對(duì)照臨床試驗(yàn)(PROGRESS)和心臟結(jié)局預(yù)防評(píng)估研究(HOPE)3個(gè)試驗(yàn)進(jìn)行綜合分析.結(jié)果顯示:降壓治療組較安慰劑對(duì)照組降低腦卒中再發(fā)危險(xiǎn)率28%,降低冠心病危險(xiǎn)率15%,降低總死亡率11%;降壓治療不僅能降低腦血管病或心血管病高危者伴高血壓的腦卒中再發(fā)危險(xiǎn),而且對(duì)未伴高血壓者也能降低其腦卒中危險(xiǎn).
結(jié)論 降壓治療對(duì)腦卒中二級(jí)預(yù)防是有益的.
引用本文： 王文,鄧卿,何華,馬麗媛. 降壓治療對(duì)腦卒中二級(jí)預(yù)防的臨床證據(jù). 中國(guó)循證醫(yī)學(xué)雜志, 2004, 04(5): 355-358. doi: 復(fù)制
| 1. | ［1］Wang W, Lin LS. Relationship between blood pressure level and stroke recurrence[J]. Chin J Hypertens, 2003; 11:106 -108. |
| 2. | ［2］PATS Collaborating Group. Post-stroke antihypertensive treatment study (PATS) , a preliminary result [ J ]. Chin Med J (Engl), 1995; 108(9) :710 -717. |
| 3. | ［3］PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood pressure-lowering regimen among 6 105 individuals with previous stroke or transient ischemic attack[J]. Lancet, 2001; 358(9 287):1 033-1 041. |
| 4. | ［4］Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G.Effects of an angiotensin-eonverting-enzyme inhibitor, ramipril,on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators[ J]. N Engl J Med, 2000; 342(3):145-153. |
| 5. | ［5］Dutch TIA Trial Group. Trial of secondary prevention with atenolol after transient ischemic attack or nondisabling ischemic stroke[J]. Stroke, 1993; 24(4) :543 -548. |
| 6. | ［6］Rodgers A, Neal B, MacMahon S. The effects of blood pressure lowering in cerebrovascular disease [ J ]. Neurol Rev Int,1997; 2:12-15. |
| 7. | ［7］Hypertension Stroke Cooperative Study Group. Effect of antihypertensive treatment on stroke recurrence[J]. J Am Med Assoc, 1974; 229:409 - 418. |
- 1. ［1］Wang W, Lin LS. Relationship between blood pressure level and stroke recurrence[J]. Chin J Hypertens, 2003; 11:106 -108.
- 2. ［2］PATS Collaborating Group. Post-stroke antihypertensive treatment study (PATS) , a preliminary result [ J ]. Chin Med J (Engl), 1995; 108(9) :710 -717.
- 3. ［3］PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood pressure-lowering regimen among 6 105 individuals with previous stroke or transient ischemic attack[J]. Lancet, 2001; 358(9 287):1 033-1 041.
- 4. ［4］Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G.Effects of an angiotensin-eonverting-enzyme inhibitor, ramipril,on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators[ J]. N Engl J Med, 2000; 342(3):145-153.
- 5. ［5］Dutch TIA Trial Group. Trial of secondary prevention with atenolol after transient ischemic attack or nondisabling ischemic stroke[J]. Stroke, 1993; 24(4) :543 -548.
- 6. ［6］Rodgers A, Neal B, MacMahon S. The effects of blood pressure lowering in cerebrovascular disease [ J ]. Neurol Rev Int,1997; 2:12-15.
- 7. ［7］Hypertension Stroke Cooperative Study Group. Effect of antihypertensive treatment on stroke recurrence[J]. J Am Med Assoc, 1974; 229:409 - 418.