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在急性缺血性中风中没有与不同静脉前血栓溶解的内血管血栓切除术:随机对照试验的网络元分析

Sitong Guo¹, Shiran Qin¹, Sitao Tan¹

¹Department of Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Frontiers in neurology

|February 13, 2024

概括

在血管内血栓切除术 (EVT) 之前,用高高血进行静脉内血栓溶解 (IVT) 可能会改善相比于薄膜血的再输液. 需要进行进一步的高质量试验,以证实尖性缺血性中风患者接受EVT时的甲与甲的有效性和安全性.

科学领域:

神经学神经学
干预心脏病学干预心脏病学
紧急医疗紧急医疗

背景情况:

目前的指导方针建议在急性缺血性中风之前进行静脉内血栓溶解 (IVT),然后进行血管内血栓切除 (EVT).
在EVT之前,作为IVT的tenecteplase与alteplase的比较有效性和安全性仍然不确定.

研究的目的:

在急性缺血性中风患者中,比较在EVT前给药的tenecteplase与alteplase的有效性和安全性.

主要方法:

进行了随机对照试验 (RCT) 的系统审查和元分析.
在PubMed,Embase,Web of Science和Cochrane图书馆进行了搜索,截至2023年9月16日.
主要结局是90天后的功能独立性 (mRS 0-2);次要结局包括再输血,死亡率和出血.

主要成果:

包括8项涉及2836名患者的RCT.
与单独使用EVT相比,阿尔特等 (0.6或0.9毫克/公斤) +EVT显示出更高的成功转血率,而特内克等 (0.25或0.4毫克/公斤) +EVT没有显著差异.
与0.25 mg/kg的单抗甲素+EVT相比,高甲素 (0.6或0.9 mg/kg) +EVT的成功再输血率较低.
任何内出血 (aICH) 的风险在0.6 mg/kg的高高位素+EVT时比单独使用EVT更高.
在IVT策略之间没有观察到功能独立性,优异结果或死亡率的显著差异.

结论:

在EVT前给药的阿尔特普拉斯可能会提高成功的再输血,而不是特内克特普拉斯.
由于样本规模不足,需要进一步进行高质量的RCT,以最终确定在该患者群体中,与阿尔特相比,甲的有效性和安全性.

关键词:

急性缺血性中风是急性缺血性中风.另一个地方.血管内血栓切除术是指血管内血栓切除术.网络元分析网络元分析没有替代品.

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