Weimar C, Kraywinkel K, Maschke M, Diener H-C
Department of Neurology, University of Duisburg-Essen, Essen, Germany.
Cerebrovasc Dis. 2006;22(5-6):429-31. doi: 10.1159/000094995. Epub 2006 Aug 11.
Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) within 3 h after onset of focal cerebral ischemia was approved in Germany in August 2000.
11 neurology departments with acute stroke units participated in the German Stroke Study Collaboration before (n = 2,925) and after (n = 3,204) approval of rt-PA in Germany and consecutively registered all patients admitted within 24 h following acute ischemic stroke.
Frequency of intravenous thrombolysis in patients admitted within 24 h after symptom onset increased from 4.8% before approval to 7.9% after approval of rt-PA. Among patients treated with rtPA, age increased significantly and the delay between symptom onset and imaging was significantly shorter in the second study period.
The observed improvement in management and quantity of intravenous thrombolysis may be explained by greater experience and greater legal security following regulatory approval of rtPA.
2000年8月德国批准在局灶性脑缺血发作3小时内静脉注射重组组织型纤溶酶原激活剂（rt-PA）进行溶栓治疗。
11个设有急性卒中单元的神经内科科室在德国批准rt-PA之前（n = 2925）和之后（n = 3204）参与了德国卒中研究协作项目，并连续登记了急性缺血性卒中发作后24小时内入院的所有患者。
症状发作后24小时内入院患者的静脉溶栓频率从批准前的4.8%增加到批准rt-PA后的7.9%。在接受rtPA治疗的患者中，年龄显著增加，且在第二个研究期间症状发作与影像学检查之间的延迟显著缩短。
rtPA监管批准后经验增加和法律保障增强，可能解释了静脉溶栓治疗在管理和数量上观察到的改善。
