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早期血栓溶解阶段和急性缺血性中风的功能性结果,在静脉血栓溶解后用内血管血栓切除术治疗

Siyu Sun¹, Kang Yuan², Hui Huang³

¹Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, People's Republic of China.

Therapeutics and clinical risk management

|December 8, 2025

概括

在急性缺血性中风 (AIS) 血管内血栓切除术 (EVT) 前两小时内给予静脉内血栓溶解 (IVT) 与更好的患者结局有关. 延迟IVT似乎不会增加诸如出血等风险.

科学领域:

神经学神经学
血管医学血管医学
干预心脏病学干预心脏病学

背景情况:

在急性缺血性中风 (AIS) 中,静脉输血栓溶解 (IVT) 的有效性随着时间的推移而下降.
在内血管血栓切除术 (EVT) 之前,时间延迟对IVT疗效的影响尚不清楚.

研究的目的:

调查IVT开始到注射时间 (ONT) 与随后接受EVT的AIS患者的结果之间的关联.
为了确定早期IVT的管理是否改善后期管理相比的结果.

主要方法:

对接受IVT的患者的多中心试验数据的回顾性分析,随后对前循环AIS进行EVT.
根据2小时的开端到针头时间 (ONT) 值,患者被分组为组.
用多变量逻辑回归和倾向分数匹配 (PSM) 来比较结果,包括不良的90天修改的兰金级分数和出血并发症.

主要成果:

在PSM之后,分析了176名患者,平均年龄为67.5岁,60.8%为女性.
晚期IVT (ONT>2小时) 与不良结果显著相关 (OR = 2.213,P = 0.032).
在早期和晚期IVT组之间,在死亡率或出血并发症方面没有发现显著差异.

结论:

在AIS患者在EVT之前早期 (在2小时内) 进行IVT,与不良结果的减少有关.
在EVT之前IVT的时间没有显著影响死亡率或出血并发症.

关键词:

发生出血发生出血缺血性中风中风预后预后预后这是治疗窗口的治疗窗口.进行血栓切除术 (thrombectomy).血栓溶解是一种血栓溶解.

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