Stroke, also known as stroke, is one of the major diseases in the world.
On May 21, surging journalists learned from the East Hospital affiliated to Tongji University that a multi center clinical research result led by Professor Li Gang's research group of the hospital was recently released at the European Stroke Organization Conference (ESOC), and simultaneously published online on the world authoritative journal New England Journal of Medicine. The research results for the first time define the "2-hour treatment time window for intensive hypotension of cerebral hemorrhage", that is, for patients with hemorrhagic stroke, the intensive hypotension treatment should be started within 2 hours of onset to reduce the systolic blood pressure to 130-140 mmHg, which can reduce the risk of disability and death by 25%.
Clinically, stroke can be divided into two types: ischemic (about 70%) and hemorrhagic (about 30%), which is the leading cause of death and disability. Pre hospital initiation intervention is the development trend of stroke treatment, and it is also the weak link in the current global stroke treatment guidelines that need to be improved urgently.
The prospective, multi center, open label, blind endpoint evaluation randomized controlled clinical trial - stroke emergency vehicle ultra early intensive hypotension study, carried out by the East Hospital affiliated to Tongji University as the main leading unit, covered 55 medical treatment units in 6 provinces and municipalities in eastern and western China, and enrolled more than 2400 patients. After eight years of exploration, it has achieved phased results. This is the world's largest pre hospital emergency clinical study of stroke so far, and also the first clinical study that clearly shows that intensive hypotension is significantly effective in patients with hemorrhagic stroke.
Li Gang said that the research carried out by his team provided high-level evidence support for the development and revision of treatment guidelines for cerebral hemorrhage, and also suggested that, like ischemic stroke, there was a golden therapeutic time window for cerebral hemorrhage at an early stage. At the same time, the study pointed out that it is the direction of future clinical research and medical practice to quickly identify cerebral hemorrhage before hospital and immediately give antihypertensive treatment.
"This is a clinical study with Chinese characteristics. In China's 120 first aid system, our ambulances are equipped with professional first-aid personnel and first-aid equipment. It is an important cornerstone for the success of this clinical study that we are qualified and qualified to launch ultra early intensive hypotension for stroke patients." Li Gang further introduced, His team has also cooperated with the 120 Emergency Center in Pudong New Area to establish a training course system and training standards. Relying on the interactive electronic medical record system and the community patient database, the pre hospital recognition rate of stroke has increased from 24% to 93%, and the vascular recanalization treatment rate has increased by 5.3%, which has won more patients effective treatment time.
Li Gang further said that the achievements of current clinical research are only phased. From the perspective of health economics, the pre hospital cerebral hemorrhage diagnostic equipment that can be popularized still needs to be further developed. At the same time, the optimal blood pressure management strategy for ischemic stroke still needs further exploration.
