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在急性缺血性中风中从alteplase转变为tenecteplase:梅奥诊所的经验

Ahmed Koriesh¹, Michael Liu, Waleed Brinjikji

¹Mayo Clinic, Rochester, MN.

The neurologist

|October 15, 2023

概括

与alteplase相比,在急性缺血性中风中使用tenecteplase显著减少了症状性内出血和增加了自发性回. 门到针的时间和90天的结果在两种血栓溶解疗法之间是相似的.

科学领域:

神经学神经学
心血管医学心血管医学
药理学药理学是指药理学的学科.

背景情况:

急性缺血性中风 (AIS) 的治疗依赖于及时的再输血疗法.
像阿尔特普拉斯这样的血栓溶解剂一直是标准的,但新的药物正在评估中.
一种纤维素特异性等离子体激活剂Tenecteplase在AIS管理中提供了潜在的优势.

研究的目的:

在AIS患者中,与alteplase相比,评估tenecteplase的临床结果.
在现实临床环境中评估基的安全性和有效性.
分析切换到tenecteplase作为标准血栓解压疗法的影响.

主要方法:

基于中心的观察性队列研究,比较甲 (2021年2月至2022年5月) 与高甲 (2019年9月至2021年2月).
纳入标准:患有急性缺血性中风的患者,接受基或基治疗.
统计分析包括描述性和比较性统计数据来评估结果.

主要成果:

甲组显示症状性内出血率显著降低 (0.65%与5%相比,P=0.027).
实验室观察到,随着使用丁氏甲,自发再通道的发生率更高 (10.4%对1.4%,P=0.038).
门到针的时间和90天的修改后的兰金度量得分在甲和高甲组之间是可比的.

结论:

甲与AIS治疗的安全性 (较低的出血) 和疗效 (更高的再通道) 的提高有关.
转换为tenecteplase并没有对门到针的时间或功能结果产生负面影响.
丁氏甲代表了急性缺血性中风的有价值的替代性血栓解压剂.

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