儿童急性缺血性中风的第一个报告的 Tenecteplase 病例 (P7-5.021)
Ahmed Elmashad1, Celia Fung1, Akash Chakravartty1
1Yale New Haven Hospital.
Neurology
|February 20, 2025
概括
丁氏甲 (TNK) 为儿科急性缺血性中风 (AIS) 提供了一个潜在的替代品. 本案例研究介绍了TNK在儿科AIS患者中首次报告的使用情况,证明了其安全性和有效性.
科学领域:
- 神经学 神经学
- 儿科中风 儿童中风
- 血栓溶解疗法 血栓溶解疗法
背景情况:
- 甲 (TNK) 是一种针对成人急性缺血性中风 (AIS) 的提议的替代性血栓缓解剂.
- 目前的儿科中风指导方针建议在症状出现后4.5小时内为两岁以上的儿童提供阿尔特普拉斯 (tPA),这些儿童患有致残的神经缺陷.
- 与阿尔特相比,TNK增加的纤维素特异性和对等离子体激活剂抑制剂的耐药性表明,与阿尔特相比,有可能改善血栓溶解.
研究的目的:
- 报告Tenecteplase (TNK) 在患有急性缺血性中风 (AIS) 的儿科患者中使用的第一个病例.
- 评估TNK作为小儿AIS病例中的血栓溶解剂的安全性和有效性.
主要方法:
- 一名15岁的男性出现了急性缺血性中风症状.
- 大脑CT和CT血管图识别了右中脑动脉中的血栓.
- 患者接受了0.25mg/kg剂量的Tenecteplase (TNK),随后进行了血管内血栓切除术.
主要成果:
- 丁氏甲剂的使用导致患者NIHSS得分的初步改善.
- 成功的内血管血栓切除术实现了完全的再通道化.
- 患者经历了完全症状的消失,恢复了基线神经功能 (NIHSS 0).
结论:
- 甲 (TNK) 可以作为一个安全和有效的替代品,以阿尔特对于小心挑选的儿科和青少年AIS患者.
- 需要进一步的儿科研究来确定TNK使用的理想候选者,最佳剂量和安全参数.
- 这一案例代表了TNK在儿科患者中治疗AIS的首次记录使用,证明了积极的结果.
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