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泰国急性缺血性脑卒中患者静脉溶栓后发生脑出血。

Intracerebral hemorrhage following intravenous thrombolysis in Thai patients with acute ischemic stroke.

机构信息

Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand.

出版信息

J Clin Neurosci. 2012 Jun;19(6):799-803. doi: 10.1016/j.jocn.2011.08.035. Epub 2012 Apr 1.

Abstract

In Asia, there is limited information regarding symptomatic intracerebral hemorrhage (ICH) in patients treated with intravenous (iv) recombinant tissue plasminogen activator (rtPA). The aim of this study was to identify independent factors associated with symptomatic ICH following iv rtPA. The study included 192 patients with acute ischemic stroke who were treated with iv rtPA. Baseline characteristics were compared between patients with or without ICH. Symptomatic ICH occurred in 5.7% of patients and asymptomatic ICH in 13.0% of patients. An international normalized ratio (INR) ≥1.0 (odds ratio [OR]=4.89, p=0.036), atrial fibrillation (OR=7.21, p=0.009) and blood glucose concentration >8.325 mmol/L (OR=9.00, p=0.004), were independent risk factors for symptomatic ICH. Atrial fibrillation (OR=3.56, p=0.012) and severe stroke (National Institutes of Health Stroke Scale ≥15; OR=8.94, p<0.001) were independent risk factors for asymptomatic ICH. The prevalence of symptomatic ICH following iv rtPA in Thai patients was comparable to previous studies.

摘要

在亚洲,关于接受静脉注射重组组织型纤溶酶原激活剂(rtPA)治疗的有症状颅内出血(ICH)患者的信息有限。本研究旨在确定与静脉注射 rtPA 后发生有症状 ICH 相关的独立因素。该研究纳入了 192 名接受静脉注射 rtPA 治疗的急性缺血性脑卒中患者。比较了有 ICH 和无 ICH 患者的基线特征。有症状 ICH 发生在 5.7%的患者中,无症状 ICH 发生在 13.0%的患者中。国际标准化比值(INR)≥1.0(比值比[OR]=4.89,p=0.036)、心房颤动(OR=7.21,p=0.009)和血糖浓度>8.325mmol/L(OR=9.00,p=0.004)是有症状 ICH 的独立危险因素。心房颤动(OR=3.56,p=0.012)和重度脑卒中(国立卫生研究院脑卒中量表≥15;OR=8.94,p<0.001)是无症状 ICH 的独立危险因素。泰国患者静脉注射 rtPA 后有症状 ICH 的发生率与既往研究相当。

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