Department of Neurology, Johns Hopkins University, School of Medicine, BA, 1550 Orleans Street, CRB-II 3M50, Baltimore, MD 21231, USA.
Stroke. 2011 Dec;42(12):3631-3. doi: 10.1161/STROKEAHA.111.625749. Epub 2011 Sep 22.
This is the first prospective evaluation of changes in systemic hematologic status following administration of intraventricular recombinant tissue-type plasminogen activator in patients with intraventricular hemorrhage (IVH).
Laboratory data from subjects enrolled onto the Clot Lysis: Evaluating Accelerated Resolution of IVH (CLEAR IVH) Trials were analyzed. We analyzed pre- and post- recombinant tissue-type plasminogen activator dosing coagulation parameters. Longer-term changes in hematologic status were studied in subjects who received the study agent after blood clot in the third/fourth ventricles had resolved radiologically.
Plasma fibrinogen increased significantly in both treatment groups. Dosing did not have a significant impact on any systemic coagulation parameters in either treatment group.
Intraventricular recombinant tissue-type plasminogen activator is unlikely to impact systemic coagulation or to compound the effects of systemic anticoagulation for deep venous thrombosis prophylaxis.
URL: http://clinicaltrials.gov. Unique identifier: NCT00650858.
这是首次前瞻性评估脑室注射重组组织型纤溶酶原激活剂（rt-PA）治疗脑室出血（IVH）后全身血液学状态的变化。
对 Clot Lysis：Evaluating Accelerated Resolution of IVH（CLEAR IVH）试验入组患者的实验室数据进行了分析。我们分析了 rt-PA 给药前后的凝血参数。对在第三/四脑室的血凝块已在影像学上消退后接受研究药物的患者进行了更长期的血液学状态变化研究。
两组患者的血浆纤维蛋白原均显著增加。在两个治疗组中，剂量均未对任何系统凝血参数产生显著影响。
脑室注射 rt-PA 不太可能影响全身凝血，也不会加重深静脉血栓形成预防的全身抗凝作用。
