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在急性缺血性中风 (SITS-ISTR) 后的3至4.5小时内使用高高血酶进行血栓溶解:一项观察性研究
Nils Wahlgren1, Niaz Ahmed, Antoni Dávalos
1Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden. nils.wahlgren@karolinska.se
Lancet (London, England)
|September 16, 2008
概括
静脉输入的阿尔特等对于缺血性中风患者是安全有效的,在症状出现后长达4.5小时治疗,扩大治疗资格超出标准的3小时窗口. 这一发现为更广泛的患者群体提供了关键的治疗选择.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 药理学 药理学 是一个学科.
背景情况:
- 静脉输入的高血是缺血性中风的标准治疗方法,在症状出现后3小时内使用.
- 分析表明,潜在的治疗效益可以延长至4.5小时.
- 中风治疗的安全实施 (SITS) 注册表捕获国际中风血栓溶解数据.
研究的目的:
- 为了比较3至4.5小时内接受静脉输入高位素治疗的缺血性中风患者的结果,与3小时内接受治疗的患者进行比较.
- 为了评估延长阿尔特治疗窗口的安全性和有效性.
主要方法:
- 对664名在3至4.5小时内接受治疗的患者进行了比较,其中11,865名患者在3小时内接受治疗.
- 数据来源于2002年至2007年间的国际中风血栓溶解注册 (ISTR) 的数据.
- 结果措施包括症状性脑内出血,死亡率和3个月后的功能独立性.
主要成果:
- 在两个治疗组之间,在症状性脑内出血率 (2.2%对1.6%),死亡率 (12.7%对12.2%) 或3个月的独立性 (58.0%对56.3%) 中没有显著差异.
- 3-4.5小时组的患者略微年轻,并没有严重的中风.
- 调整后的分析显示出出血和死亡风险增加的趋势,但结果没有统计学意义.
结论:
- 静脉输入的阿尔特等剂在3至4.5小时窗口内治疗的缺血性中风患者中是安全的.
- 这种延长的时间框架为那些不符合标准3小时标准的患者提供了至关重要的治疗选择.
- 这些发现支持在符合条件的缺血性中风患者中扩大阿尔泰的使用范围.
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