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针对急性缺血性中风的不同剂量基的比较疗效和安全性:系统性审查和网络元分析
Karan Srisurapanont1, Ekdanai Uawithya2, Poonyasit Dhanasomboon2
1Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
概括
甲 (TNK) 在急性缺血性中风 (AIS) 中提供与甲 (ALT) 相似的疗效和安全性. 对于AIS患者来说,TNK的0.25 mg/kg剂量似乎是最佳的,在老年人中显示出良好的结果和减少症状性内出血.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 甲酸 (TNK) 是急性缺血性中风 (AIS) 的新兴血栓解压剂.
- 在AIS群体中不同剂量的TNK有效性和安全性的临床数据需要进一步澄清.
- 阿尔特等 (ALT) 0.90 mg/kg是目前用于AIS的标准血栓解压疗法.
研究的目的:
- 在AIS患者中,将各种Tenecteplase (TNK) 剂量的疗效和安全性与其他Tenecteplase (TNK) 剂量和Alteplase (ALT) 剂量进行比较.
- 为了确定治疗急性缺血性中风的最佳TNK剂量.
主要方法:
- 在PubMed,Scopus,Cochrane和Embase进行了系统的文献搜索.
- 贝叶斯网络元分析进行了比较TNK剂量和ALT0.90 mg/kg.
- 结果包括再输,功能性结果 (mRS 0-1, 0-2),死亡率和内出血 (ICH).
主要成果:
- 分析了11项涉及5423名参与者的试验.
- 在TNK剂量和ALT之间没有发现对再输血,mRS或死亡率的显著差异.
- 与ALT相比,TNK 0.25 mg/kg显示出有利的安全性,包括较低的症状ICH在老年患者中.
结论:
- 甲 (TNK) 在急性缺血性中风中表现出与甲 (ALT) 相似的疗效和安全性.
- 建议TNK 0.25 mg/kg作为最佳剂量,平衡有效性和安全性.
- 更高的TNK剂量 (例如0.40 mg/kg) 可能会增加症状性内出血的风险.
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