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急性缺血性卒中患者静脉溶栓治疗的应用:临床结局评估

Use of Intravenous Thrombolytic Therapy in Acute Ischemic Stroke Patients: Evaluation of Clinical Outcomes.

作者信息

Zhang Pei-Lan, Wang Yu-Xin, Chen Yan, Zhang Chen-Hao, Li Chen-Hua, Dong Zhong, Yin Hang, Zhang Fang-Fang, Wang Jin-Huan

机构信息

Department of Neurology, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China.

出版信息

Cell Biochem Biophys. 2015 May;72(1):11-7. doi: 10.1007/s12013-014-0394-6.

Abstract

The use of intravenous thrombolytic therapy (ITT) in acute ischemic stroke (AIS) patients is still debated in China. We present the analysis of clinico-demographic retrospective data of 646 AIS patients that were treated by alteplase ITT at our hospital. The data collected included age, gender, education, income, drug use before disease onset, and awareness of stroke/ITT. The risk factors studied were hypertension, diabetes, hyperlipidemia, atrial fibrillation, coronary heart disease, cerebral infarction, transient ischemic attack, valvular heart disease, thyroid disease, migraine, asymptomatic carotid stenosis, family history of stroke, hyperhomocysteinemia, smoking, drinking, and gingivitis. Pre-ITT patient data included blood pressure and time from onset to hospital. Post-ITT patient data included National Institutes of Health Stroke Scale (NIHSS) scores, clinical outcome, revascularization, hemorrhage, healing rate, and 90-day mortality. Hospital management information included monthly ITT cases, discharges, bed turnaround times, length of hospital stay, bed utilization, drug ratio, massive cerebral infarction decompressive craniectomy, and social impact. Prognosis evaluation was based on post-ITT NIHSS and modified Rankin Scale (mRS) scores. We found that ITT success rate was 75.85 %, with a bleeding rate of 1.55 % and a 90-day mortality rate of 2.01 %. Overall, the data suggest that the ITT therapy was highly successful in AIS patients treated at our hospital.

摘要

在中国,急性缺血性卒中(AIS)患者使用静脉溶栓治疗(ITT)仍存在争议。我们对我院646例接受阿替普酶ITT治疗的AIS患者的临床人口统计学回顾性数据进行了分析。收集的数据包括年龄、性别、教育程度、收入、发病前用药情况以及对卒中/ITT的认知。研究的危险因素包括高血压、糖尿病、高脂血症、心房颤动、冠心病、脑梗死、短暂性脑缺血发作、心脏瓣膜病、甲状腺疾病、偏头痛、无症状性颈动脉狭窄、卒中家族史、高同型半胱氨酸血症、吸烟、饮酒和牙龈炎。ITT治疗前患者数据包括血压和发病至入院时间。ITT治疗后患者数据包括美国国立卫生研究院卒中量表(NIHSS)评分、临床结局、血管再通、出血情况、治愈率和90天死亡率。医院管理信息包括每月ITT病例数、出院人数、床位周转时间、住院时间、床位使用率、药物比例、大面积脑梗死减压颅骨切除术以及社会影响。预后评估基于ITT治疗后的NIHSS和改良Rankin量表(mRS)评分。我们发现ITT成功率为75.85%,出血率为1.55%,90天死亡率为2.01%。总体而言,数据表明ITT治疗在我院治疗的AIS患者中非常成功。

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