在接受用特内克或阿尔特进行过桥梁治疗的患者中,早期再通道化
Thomas Checkouri1,2, Gaspard Gerschenfeld1,2, Pierre Seners3,4,5
1AP-HP, Service des Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Hôpital Saint-Antoine, Sorbonne Université, Paris, France (T.C., G.G., M.Y., S.A.).
Stroke
|August 25, 2023
概括
甲和高甲在急性缺血性中风中表现出类似的早期再通道化率. 然而,tenecteplase在实现更长时间的血栓再通道化方面表现出更高的疗效.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 紧急医疗 紧急医疗
背景情况:
- 静脉内血栓溶解 (IVT) 采用高高或高低是大血管封闭急性缺血性中风的标准.
- 基和高之间的早期再通道化 (ER) 比较率的数据是相互矛盾的.
- 有限的研究存在于ER预测因子分层的差异效应,如评估时间和血栓特征.
研究的目的:
- 为了比较IVT后的ER的可能性与前部循环中tenecteplase与alteplase相比,大血管封闭急性缺血性中风.
- 根据IVT-to-ER评估时间,阻塞部位和血栓长度来调查ER率的潜在差异.
主要方法:
- 两家法国多中心注册局的回顾性分析 (PREDICT-RECANAL用于阿尔特酶,Tenecteplase治疗缺血性中风中的Tenecteplase治疗).
- 倾向性得分重叠权重和调整后勤回归被用于分析.
- 基于预先建立的ER预测器进行了分层分析.
主要成果:
- 整体ER率相似:19.8%的甲和18.5%的高甲 (OR,1.09;P=0.52).
- 对于血栓长度 (P=0.003) 观察到显著的相互作用,而基体显示出高于10毫米的血栓 ER 几率 (OR,2.43;P=0.04).
- 对于IVT-to-ER评估时间 (P=0.40) 或闭塞部位 (P=0.80) 没有发现显著的差异效应.
结论:
- 在大约五分之一的患有大血管封闭急性缺血性中风的患者中,tenecteplase和alteplase都能达到ER.
- 与阿尔特相比,在患有较大的血栓的患者中,坦克特与ER的可能性增加了2倍.
- 在IVT-to-ER评估时间和闭塞部位方面没有发现显著的相互作用,这表明这些因素的疗效相似.
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