Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Int J Stroke. 2013 Oct;8(7):588-90. doi: 10.1111/j.1747-4949.2012.00826.x. Epub 2012 Aug 1.
Twelve million people develop ischemic stroke each year world over and 30-40% of them do not have arterial occlusions at presentation. Trials conducted to study the efficacy of thrombolytic drug reported better outcome with use of thrombolytic drug but none studied the subtypes of ischemic strokes specifically and adequately. The subgroups of patients with no arterial occlusion at presentation continue to receive thrombolytic therapy without proven benefit and with some risk.
The aim of this article is to study whether intravenous thrombolysis with alteplase improves clinical outcome in ischemic stroke patients who do not have arterial occlusion at presentation.
A retrospective medical record-based observational multicenter, multinational study.
Primary outcome measure would be clinical outcome at three-months from stroke onset measured by modified Rankin Scale and National Institute of Health Stroke Scale. Secondary outcome measure will be frequency of intracerebral hemorrhage causing worsening of clinical deficit defined as increase in National Institute of Health Stroke Scale by >4.
全世界每年有 1200 万人患有缺血性脑卒中，其中 30-40%的患者在发病时没有动脉闭塞。为了研究溶栓药物的疗效而进行的试验报告称，使用溶栓药物可获得更好的结果，但没有一项试验专门且充分地研究缺血性脑卒中的亚型。在发病时没有动脉闭塞的患者亚组继续接受溶栓治疗，但没有证实其有益，且存在一定风险。
本研究旨在探讨阿替普酶静脉溶栓是否能改善发病时无动脉闭塞的缺血性脑卒中患者的临床预后。
回顾性基于病历的观察性多中心、多国研究。
主要结局指标为发病后三个月时改良 Rankin 量表和国立卫生研究院卒中量表评估的临床结局。次要结局指标为颅内出血的频率，颅内出血导致临床缺损恶化的定义为国立卫生研究院卒中量表增加>4。
