Murray Veronica, Norrving Bo, Terént Andreas, Wester Per
Medicinska kliniken, Danderyds sjukhus, Stockholm.
Lakartidningen. 2004 Feb 19;101(8):662-8, 670-3.
Thrombolysis is a highly promising treatment in acute ischaemic stroke. There is evidence of positive effects at least up to three hours and most probably up to six. The risk of intracranial haemorrhage is increased fourfold with thrombolysis; risk factors other than the treatment as such have not been identified for certain; the risk is not related to giving thrombolysis during the 0-3 as opposed to the 3-6 hour time window. There is a non-significant excess of deaths, ranging from a small reduction to a substantial excess. There is not enough evidence to answer several questions regarding the influence of patient- and stroke characteristics on effectsize; death; and risk of intracranial haemorrhage. Giving priority to new large randomized controlled trials is essential to achieve this knowledge.
溶栓治疗在急性缺血性卒中方面是一种极具前景的治疗方法。有证据表明其至少在三小时内有积极效果，很可能在六小时内也有效果。溶栓治疗会使颅内出血风险增加四倍；除治疗本身外，尚未明确确定其他危险因素；风险与在0至3小时而非3至6小时时间窗内进行溶栓治疗无关。死亡人数有非显著的过量，从略有减少到大幅过量不等。关于患者和卒中特征对效应大小、死亡以及颅内出血风险的影响，没有足够证据回答几个问题。优先开展新的大型随机对照试验对于获取这些知识至关重要。
