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静脈内血栓溶解を施した脳卒中患者の早期再発性缺血性脳卒中
Dimitrios Georgiadis1, Stefan Engelter, Barbara Tettenborn
1Department of Neurology, University of Zürich, Frauenklinikstrasse 26, 8091 Zürich, Switzerland. Dimitrios.Georgiadis@usz.ch
Circulation
|July 13, 2006
まとめ
早期再発性不全性脳卒中は,静脈内血栓溶解を受けている患者ではまれで,症例の1%未満で発生します. 症状のある頭蓋内出血はより一般的で,治療後のタイミングが異なります.
科学分野:
- 神経学 神経学とは
- 心血管医学 心血管医学
- 緊急医療 緊急医療
背景:
- 静脈内組織型プラズミノゲン活性化剤 (tPA) を投与された患者における早期再発性不全性脳卒中の発生率の評価.
- 再発性不全性脳卒中と症状性脳内出血 (ICH) の時間的パターンを比較する.
研究 の 目的:
- tPA治療後の早期再発性缺血性脳卒中の頻度を測定する.
- 急性脳卒中患者における再発性不全性脳卒中と症状性ICHのタイミングを比較する.
主な方法:
- tPA.治療を受けた341人の急性脳卒中患者の将来的に収集された,人口ベースのデータを遡及的に分析した.
- 主なアウトカム: 24時間以内の神経学的悪化 (NIH ストロークスケールで≥4ポイント),再発性不全性脳卒中または症状のあるICHに起因する.
- 2001年1月から2004年11月の間にスイスの8つの医療センターから収集されたデータです.
主要な成果:
- 早期再発性不全性脳卒中は,患者の0.59% (2/341) で発生しました.
- 症状のあるICHは,患者の4.40% (15/341) で発生しました.
- トロンボリシス中に再発性不全性脳卒中が発生し,症状のあるICHは,輸注後2〜22時間後に発生しました.
結論:
- 再発性不全性脳卒中は,静脈血栓溶解を受けている急性脳卒中患者の早期神経学的悪化の珍しい原因です.
- 再発性不全性脳卒中の一時的な発生は,症状のあるICHの発生と有意に異なります.
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