在急性中枢视网膜动脉阻塞中对 Tenecteplase 的随机试验
Stephen J Ryan1,2,3, Øystein Kalsnes Jørstad2,4, Mona Skjelland1,2
1Department of Neurology, Oslo University Hospital, Oslo.
The New England journal of medicine
|January 28, 2026
概括
与阿司匹林相比,用tenecteplase治疗中枢视网膜动脉封闭并没有改善视力. 这项研究没有发现显著的视力恢复益处,并指出有严重的安全问题与tenecteplase.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 血管医学 血管医学
背景情况:
- 中央视网膜动脉封闭 (CRAO) 是一种导致不可逆转的视力丧失的危急状况.
- 目前对CRAO的治疗选择有限,并且通常是无效的.
研究的目的:
- 在急性中枢视网膜动脉封闭的患者中,与口服阿司匹林相比,评估静脉注射的丁氏的疗效和安全性.
- 为了确定tenacteplase是否能在症状出现后4.5小时内改善视力恢复.
主要方法:
- 一个第三阶段,双盲,随机对照试验与78名患有急性非动脉炎CRAO的成年患者进行.
- 患者接受了静脉注射的丁氏甲 (0.25毫克/千克) 或口服阿司匹林 (300毫克),主要终点是视力恢复 (30天最佳校正视力敏度≤0.7 logMAR).
主要成果:
- 视力恢复率在30天后是类似的,在甲组 (20%) 和阿司匹林组 (24%).
- 在治疗组之间的二次视觉结果测量中没有观察到实质性的差异.
- 乙烯基甲基酶组的不良事件发生率较高,其中包括1次致命的内出血.
结论:
- 与口服阿司匹林相比,在CRAO发作后4.5小时内给予静脉注射的太尼克拉斯并没有显示出优异的视力恢复.
- 甲治疗与严重的安全问题有关,包括严重的出血事件.
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