ChiCTR2600125361 版本V1.0 版本创建时间2026/05/26 10:35:46 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600125361 

最近更新日期:

Date of Last Refreshed on:

2026-05-26 10:35:40 

注册时间:

Date of Registration:

2026-05-26 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

急性缺血性卒中中等血管闭塞治疗策略远期预后比较:一项基于真实世界数据模拟目标试验的研究

Public title:

Long-Term Outcomes of Treatment Strategies for Acute Ischemic Stroke with Medium Vessel Occlusion: A Target Trial Emulation Study Based on Real-World Data

注册题目简写:

English Acronym:

研究课题的正式科学名称:

急性缺血性卒中中等血管闭塞治疗策略远期预后比较:一项基于真实世界数据模拟目标试验的研究

Scientific title:

Long-Term Outcomes of Treatment Strategies for Acute Ischemic Stroke with Medium Vessel Occlusion: A Target Trial Emulation Study Based on Real-World Data

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

黎祺 

研究负责人:

徐运 

Applicant:

Li Qi 

Study leader:

Xu Yun 

申请注册联系人电话:

Applicant telephone:

+86 131 0085 8763

研究负责人电话:

Study leader's
telephone:

+86 139 1476 4479

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

liqiys2023@163.com

研究负责人电子邮件:

Study leader's E-mail:

xuyun20042001@aliyun.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

江苏省南京市中山路321号

研究负责人通讯地址:

江苏省南京市中山路321号

Applicant address:

No. 321, Zhongshan Road, Gulou District, Nanjing, Jiangsu, China

Study leader's address:

No. 321, Zhongshan Road, Gulou District, Nanjing, Jiangsu, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

南京鼓楼医院

Applicant's institution:

Nanjing Drum Tower Hospital

研究负责人所在单位:

南京鼓楼医院

Affiliation of the Leader:

Nanjing Drum Tower Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025-1267-02

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

南京大学医院学附属鼓楼医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Nanjing Drum Tower Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-02-02 00:00:00

伦理委员会联系人:

黄季晨

Contact Name of the ethic committee:

Huang Jicheng

伦理委员会联系地址:

中国江苏省南京市鼓楼区中山路321号

Contact Address of the ethic committee:

No. 321, Zhongshan Road, Gulou District, Nanjing, Jiangsu, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 25 6818 2923

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

南京鼓楼医院

Primary sponsor:

Nanjing Drum Tower Hospital

研究实施负责(组长)单位地址:

中国江苏省南京市鼓楼区中山路321号

Primary sponsor's address:

No. 321, Zhongshan Road, Gulou District, Nanjing, Jiangsu, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

江苏

市(区县):

南京

Country:

China

Province:

Jiangsu

City:

Nanjing

单位(医院):

南京鼓楼医院

具体地址:

中国江苏省南京市鼓楼区中山路321号

Institution
hospital:

Nanjing Drum Tower Hospital

Address:

No. 321, Zhongshan Road, Gulou District, Nanjing, Jiangsu, China

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-selected topic (self-funded)

研究疾病:

急性缺血性卒中  

Target disease:

Acute ischemic stroke

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

回顾性研究 

Study phase:

Retrospective study

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

1. 主要目的: 比较 EVT 与 BMT 治疗 MeVO 卒中患者的 1 年功能预后(mRS 评分)。 2. 次要目的: 评估 1 年综合预后(功能独立、生活质量、认知情绪状态);识别良好预后的预测因 素;探索 EVT 在特定亚组中的疗效。 3. 探索性目的: 分析 EVT 与长期认知功能、社会回归的相关性。  

Objectives of Study:

1.Primary Objective: To compare the 1-year functional outcomes (mRS score) between EVT and BMT in patients with MeVO stroke. 2.Secondary Objectives: To assess the 1-year comprehensive outcomes (functional independence, quality of life, cognitive and emotional status); identify predictors of favorable prognosis; and explore the efficacy of EVT in specific subgroups. 3.Exploratory Objective: To analyze the correlation of EVT with long-term cognitive function and social reintegration.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1. 在 2022.01.01 至 2025.06.30期间于参研单位住院治疗的患者; 2. 年龄 18 周岁以上; 3. 卒中前改良 Rankin 量表评分 <= 2 分; 4. 根据临床症状或影像检查初步判断为急性脑卒中; 5. 经 CTA 或 MRA 证实为孤立性中等血管闭塞(定义为大脑中动脉 M2、M3 或 M4 段闭塞;大脑前动脉的 A1、A2 或 A3 段闭塞;大脑后动脉的 P1、P2 或 P3 段闭塞); 6. 发病至就诊时间 <= 6 小时。对影像学提示存在可挽救脑组织的患者(因目前随机对照研究均呈现阴性结果,所以缺乏明确的筛选标准。为了探寻可能获益的影像指标,我们选择较为宽松的入组标准:方案 A.基于灌注成像,不匹配比率 >= 1.2;方案 A不适用时(如部分中心缺乏高阶影像设备,或欠缺分析软件等),则采用方案 B.CT标准:在灌注 CT 的低灌注区域 >= 40% 的区域内,平扫 CT 上无低密度;或 MRI 标准:存在扩散-高信号不匹配(在扩散加权成像 (DWI) 病灶区域 >= 40% 的区域内,液体衰减反转恢复 (FLAIR) 成像上无高信号),时间窗延长至 24 小时); 7. 入院时 NIHSS 评分 >= 4 分或症状明显致残(例如失语,偏盲等)。

Inclusion criteria

1. Patients hospitalized at the participating centers between January 1, 2022, and June 30, 2025; 2. Aged 18 years or older; 3. Pre-stroke modified Rankin Scale score <= 2; 4. Initial clinical or imaging diagnosis of acute ischemic stroke; 5. Confirmed isolated medium vessel occlusion by CTA or MRA (defined as occlusion of the M2, M3, or M4 segment of the middle cerebral artery; A1, A2, or A3 segment of the anterior cerebral artery; or P1, P2, or P3 segment of the posterior cerebral artery); 6. Time from symptom onset to hospital arrival <= 6 hours. For patients with imaging evidence of salvageable brain tissue (given negative results from current randomized controlled trials, explicit selection criteria are lacking. To explore potential imaging markers of benefit, we adopt relatively broad inclusion criteria: Option A: Based on perfusion imaging, mismatch ratio >= 1.2; if Option A is not applicable (e.g., some centers lack advanced imaging equipment or analytical software), Option B is used: CT criteria: no hypodensity on non-contrast CT within >= 40% of the hypoperfusion region on perfusion CT; or MRI criteria: diffusion-FLAIR mismatch (no hyperintensity on FLAIR within >= 40% of the diffusion-weighted imaging (DWI) lesion area), with the time window extended to 24 hours); 7. Admission NIHSS score >= 4 or clearly disabling symptoms (e.g., aphasia, hemianopia, etc.).

排除标准:

1. 合并大血管闭塞; 2. 神经功能缺损症状轻微或迅速好转(接受任何治疗前); 3. 影像学提示闭塞可能为其他原因(如动脉夹层、血管炎、烟雾病); 4. 合并其他可能影响预后的颅内病变(如大的未破裂动脉瘤、动静脉畸形、颅内肿瘤); 5. 既往有严重神经系统或精神疾病,且有碍于评估神经功能; 6. 多支血管闭塞病变(例如:双侧前循环,或前后循环均闭塞); 7. 伴有预期寿命<1年的严重全身性疾病(如晚期癌症、终末期肝肾功能衰竭); 8. 预期不能完成随访。

Exclusion criteria:

1. Concurrent large vessel occlusion; 2. Mild or rapidly improving neurological deficit (prior to any treatment); 3. Imaging suggests the occlusion may be due to other causes (e.g., arterial dissection, vasculitis, moyamoya disease); 4. Presence of other intracranial pathologies that may affect prognosis (e.g., large unruptured aneurysm, arteriovenous malformation, intracranial tumor); 5. History of severe neurological or psychiatric disease that may interfere with neurological assessment; 6. Multiple vessel occlusions (e.g., bilateral anterior circulation or combined anterior and posterior circulation occlusions); 7. Severe systemic disease with a life expectancy of <1 year (e.g., advanced cancer, end-stage liver or kidney failure); 8. Inability to complete follow-up as anticipated.

研究实施时间:

Study execute time:

From 2025-12-01 00:00:00 To 2026-12-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-02-02 00:00:00 To 2026-05-30 00:00:00

干预措施:

Interventions:

组别:

血管内治疗组

样本量:

537

Group:

Intravascular treatment group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

标准药物组

样本量:

358

Group:

Standard medical management

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南京鼓楼医院 

单位级别:

三甲 

Institution
hospital:

Nanjing Drum Tower Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南京市第一医院 

单位级别:

三甲 

Institution
hospital:

Nanjing First Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

黑龙江省 

市(区县):

 

Country:

China

Province:

Heilongjiang

City:

单位(医院):

哈尔滨医科大学附属第二医院 

单位级别:

三甲 

Institution
hospital:

The Second Affiliated Hospital of Harbin Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

徐州中心医院 

单位级别:

三甲 

Institution
hospital:

XuZhou Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

无锡人民医院 

单位级别:

三甲 

Institution
hospital:

Wuxi People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广州 

市(区县):

 

Country:

China

Province:

Guangzhou

City:

单位(医院):

暨南大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Jinan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南通大学附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Nantong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南京医科大学第二附属医院 

单位级别:

三甲 

Institution
hospital:

The Second Clinical Medical College of Nanjing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

盐城市第一人民医院 

单位级别:

三甲 

Institution
hospital:

Yancheng First People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

盐城市第三人民医院 

单位级别:

三甲 

Institution
hospital:

Yancheng Third People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

徐州医科大学附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Xuzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江南大学附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated hospital of jiangnan university

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

兴化市人民医院 

单位级别:

三甲 

Institution
hospital:

Xinghua People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

无锡市惠山区人民医院 

单位级别:

三级 

Institution
hospital:

Wuxi Huishan District People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

泰兴市人民医院 

单位级别:

三甲 

Institution
hospital:

Taixing People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南通大学附属海安医院 

单位级别:

三级 

Institution
hospital:

Affiliated Haian Hospital of Nantong University

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

绵阳市中心医院 

单位级别:

三甲 

Institution
hospital:

Mianyang Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

内蒙古 

市(区县):

 

Country:

China

Province:

Neimenggu

City:

单位(医院):

包头市中心医院 

单位级别:

三甲 

Institution
hospital:

Baotou Central Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

1 年时的 mRS 评分

指标类型:

主要指标

Outcome:

MRS score at 1 year

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

功能独立比例(定义为 mRS <=2)

指标类型:

次要指标

Outcome:

Functional independence ratio (defined as mRS <= 2)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

欧洲五维健康量表(EQ-5D-5L)评分

指标类型:

次要指标

Outcome:

European Five Dimensional Health Scale (EQ-5D-5L) score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

巴氏指数评分

指标类型:

次要指标

Outcome:

Barthel Index score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

患者健康问卷-4(PHQ-4)评分

指标类型:

次要指标

Outcome:

Patient Health Questionnaire-4 (PHQ-4) Score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

1 年全因死亡率

指标类型:

副作用指标

Outcome:

1-year all-cause mortality rate

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

1 年内症状性卒中复发(经影像学证实)

指标类型:

副作用指标

Outcome:

Symptomatic stroke recurrence within 1 year (confirmed by imaging)

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

1 年内是否因卒中事件再次入院

指标类型:

副作用指标

Outcome:

Number of readmissions due to stroke events within one year

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

不适用

Randomization Procedure (please state who generates the random number sequence and by what method):

Not applicable

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

None

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

国家生物信息中心 China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/)。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/).

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

使用电子数据采集系统(EDC),源数据来自电子病历。电子与纸质资料保存至研究结束后至少 5 年。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

An Electronic Data Capture (EDC) system is used, with the data source being electronic medical records. Both electronic and paper documents shall be preserved for at least 5 years after the completion of the study.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-05-26 10:35:40