血栓切除术前的IV血栓切除剂与单独的血栓切除术相比,在因大血管封闭而发生中风的患者中
Gaspard Gerschenfeld1,2,3,4, Bertrand Lapergue4,5, Pierre Seners3,4,6
1AP-HP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Neurology
|February 12, 2026
概括
与单独使用EVT相比,Tenecteplase加血管内血栓切除 (TNK + EVT) 改善了大血管封闭性中风患者的功能结果. 在中风治疗中,这种益处在4.5小时内被观察到,并且不依赖时间.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 脑卒中医学 脑卒中医学
背景情况:
- 在血管内血栓切除术 (EVT) 之前使用高高的静脉内血栓溶解 (IVT) 显示出对大血管封闭 (LVO) 中风的有限,时间依赖的益处.
- 关于替代性血栓溶解药物基酶的数据很少.
- 这项研究涉及基酶加EVT (TNK + EVT) 与单独EVT的疗效和安全性.
研究的目的:
- 在LVO中风患者中,评估TNK+EVT与单独EVT相比的疗效和安全性.
- 为了确定TNK + EVT的潜在益处是否随着治疗时间的推移而减少.
- 在中风后3个月评估功能结果.
主要方法:
- 对两个全国性注册表 (TETRIS和ETIS) 的回顾性聚合分析.
- 纳入标准:前部循环LVO中风,症状出现后4.5小时内,没有血栓溶解禁忌.
- 倾向性评分加权后勤回归用于分析修改的兰金表 (mRS) 评分和安全结果.
主要成果:
- 与单独使用EVT相比,TNK + EVT与显著改善的3个月功能结果 (mRS ≤2) 相关 (OR 1.50;P<0.001).
- 在不同中风中心,TNK+EVT的益处是一致的,并且根据发作到血栓溶解的时间,在统计上没有差异.
- 两组之间没有明显的差异在膜性血液瘤或症状性脑内出血的发病率.
结论:
- 与单独使用EVT相比,TNK + EVT在LVO中风患者中表现出优异的功能结果,在4.5小时内治疗.
- 观察到的TNK + EVT的好处并不依赖于时间,也没有增加安全问题.
- 这些发现支持在中风管理的早期时间窗口内,在EVT前常规使用tenecteplase.
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