相关实验视频
Updated: May 5, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
在4.5至24小时内治疗中风的基,并进行 perfusion-imaging 选择
Gregory W Albers1, Mouhammad Jumaa1, Barbara Purdon1
1From Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto (G.W.A., N.E.S., M.G.L.), Genentech, South San Francisco (B.P., M.Y., L.M., X.-Y.L., G.A.R.), and the Department of Neurology, Southern California Permanente Medical Group, Los Angeles Medical Center (N.S.), and the Department of Neurology, University of California, Los Angeles (D.S.L.), Los Angeles - all in California; the Department of Neurology, ProMedica Toledo Hospital, University of Toledo, Toledo (M.J., S.F.Z.), and the Department of Emergency Medicine (C.E.K.) and the Department of Neurology and Rehabilitation Medicine, University of Cincinnati Gardner Neuroscience Institute (J.P.B.), College of Medicine, University of Cincinnati, Cincinnati - both in Ohio; the Department of Neurology, University of Minnesota, Minneapolis (C.S.); the Department of Medicine, University of Alberta, Edmonton, Canada (A.S.); the Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago (M.K.); Vanderbilt Cerebrovascular Program, Vanderbilt University Medical Center, Nashville (M.T.F.); Oregon Stroke Center, Oregon Health and Science University, Portland (W.M.C.); the School of Medicine, University of New South Wales, Sydney (K.B.), and the Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC (B.C.V.C.) - both in Australia; the Department of Neurology, Cleveland Clinic Florida, Weston Hospital, Weston (A.N.); the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and the Department of Neurology, Yale School of Medicine, New Haven, CT (L.H.S.).
丁氏甲并没有改善4.5至24小时内接受治疗的缺血性中风患者的结局,即使有血栓切除术. 该研究发现,与安慰剂相比,临床结果或出血率没有显著差异.
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:
- 血栓溶解剂,如丁氏甲,在4.5小时内是缺血性中风的标准.
- 除了这个4.5小时的窗口之外,关于tenecteplase疗效的数据有限.
研究的目的:
- 为了评估与安慰剂相比,在出现症状发作后4.5至24小时的缺血性中风患者中,基的有效性和安全性.
- 评估使用修改的兰金级别和安全结果的临床结果,包括死亡率和出血.
主要方法:
- 一个多中心,双盲,随机,安慰剂对照试验.
- 包括患有缺血性中风,中脑动脉或内动脉堵塞的患者,以及在 perfusion 影像上可挽救的组织.
- 在最后一个已知的时间后4.5-24小时内给药tenecteplase (0.25 mg/kg) 或安慰剂.
主要成果:
- 招募了458名患者,77.3%接受了血栓切除术.
- 在90天后,中位数修改的兰金度量得分在基和安慰剂组均为3 (OR1.13,P=0.45).
- 90天的死亡率为19.7%与丁氏甲相比18.2%与安慰剂;症状性内出血是3.2%与2.3%.
结论:
- 与安慰剂相比,中风后4.5-24小时开始服用tenecteplase并没有改善主要动脉封闭患者的临床结果,其中许多人接受了血栓切除术.
- 症状性脑内出血的发生率在基和安慰剂组之间是相似的.
相关概念视频
Acute Coronary Syndrome IV: Interprofessional Care
Cardiopulmonary Resuscitation IV: Pharmacological Management
Ischemic Stroke ll: Pathophysiology
Transient Ischemic Attack l: Introduction

