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对于急性缺血性中风的达比加特兰逆转后的血栓溶解:基于国家注册的研究和元分析
Aikaterini Theodorou1, Konstantinos Melanis1, Eleni Bakola1
1From the Second Department of Neurology (A.T., K.M., E.B., M.C., M.I.S., L.P., S.G., G.T.), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens; Department of Neurology (A.K., P.P.), Korgialenio-Benakio Greek Red Cross General Hospital of Athens; Stroke Unit (K.P., A. Safouris, O.K.), Metropolitan Hospital, Piraeus; Department of Neurology (E.N.), School of Medicine, University of Ioannina, Greece; Department of Neurology (A. Sarraj), University Hospital Cleveland Medical Center, Case Western Reserve University, OH; Department of Neurology (D.J.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
在用达比加特兰逆转后,急性缺血性中风 (AIS) 的静脉输血栓溶解 (IVT) 是安全有效的. 这种治疗显示出与没有达比加特兰预治疗的患者相似的结果,具有更高的良好功能恢复的可能性.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于治疗急性缺血性中风 (AIS) 的静脉静脉血栓溶解 (IVT) 安全性,在达比加特兰与伊达鲁齐祖马布逆转后,存在有限的数据.
- 在接受IVT的AIS患者中评估idarucizumab预治疗的安全性和有效性至关重要.
研究的目的:
- 为了评估IVT在AIS患者的安全性和有效性,在达比加特兰与idarucizumab逆转后.
- 为了比较接受IVT的患者与以前的达比加逆转和没有达比加逆转之间的结果.
主要方法:
- 一个基于国家注册的研究和对队列研究和病例系列的系统审查/元分析.
- 评估症状性内出血 (sICH),任何内出血,3个月死亡率和功能结果 (mRS 0-1,0-2).
主要成果:
- 在553名患者中,聚合的SICH病率为4%,任何内出血为10%,3个月死亡率为18%.
- 与没有达比加特兰预治疗的患者相比,sICH,任何出血或死亡率没有显著差异.
- 伊达鲁齐祖马布预治疗与3个月后良好功能结果的可能性更高有关 (RR 1.35).
结论:
- 在观察性研究中,在达比加特兰与伊达鲁齐祖马布逆转后进行IVT似乎是安全和有效的.
- 需要进一步的随机对照试验来证实这些发现在这个特定的AIS子组.
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