接受和未接受静脉溶栓治疗的大脑中动脉大面积梗死患者的预后。
Outcomes of patients with large middle cerebral artery infarct treated with and without intravenous thrombolysis.
作者信息
Dharmasaroja Pornpatr A, Muengtaweepongsa Sombat
机构信息
Department of Internal Medicine, Stroke and Neurodegenerative Diseases Research Unit, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand.
Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand.
出版信息
J Neurosci Rural Pract. 2016 Jan-Mar;7(1):36-9. doi: 10.4103/0976-3147.172149.
BACKGROUND
Many thrombolytic studies showed that severe stroke was associated with death and having symptomatic intracerebral hemorrhage and inversely related to a favorable outcome.
AIMS
The purpose of this study is to compare the outcomes of patients with acute large middle cerebral artery (MCA) infarction with and without intravenous recombinant-tissue-plasminogen activator (rtPA) treatment.
METHODS
Patients with acute, large MCA infarction (National Institute of Health Stroke Scale [NIHSS] >15) who were treated during 2011-2014 were studied. The demographic data and the outcomes were compared between patients with and without intravenous rtPA treatment.
RESULTS
Two hundred and forty patients were included. Mean NIHSS score was 20. One hundred and twenty patients were treated with intravenous rtPA treatment. The patients with rtPA treatment had higher rates of favorable outcomes (39% vs. 17%, P < 0.001) and lower mortality rate (16% vs. 51%, P < 0.001). There was no significant difference in the occurrence of symptomatic intracerebral hemorrhage (6% vs. 4%, P = 0.715).
CONCLUSIONS
The study showed the benefit and safety of intravenous rtPA treatment in patients with acute large MCA infarct.
背景
许多溶栓研究表明，严重卒中与死亡及症状性脑出血相关，且与良好预后呈负相关。
目的
本研究旨在比较接受和未接受静脉注射重组组织型纤溶酶原激活剂（rtPA）治疗的急性大脑中动脉（MCA）大面积梗死患者的预后。
方法
对2011年至2014年期间接受治疗的急性MCA大面积梗死患者（美国国立卫生研究院卒中量表[NIHSS]>15）进行研究。比较接受和未接受静脉rtPA治疗患者的人口统计学数据和预后。
结果
纳入240例患者。平均NIHSS评分为20分。120例患者接受了静脉rtPA治疗。接受rtPA治疗的患者有更高的良好预后率（39%对17%，P<0.001）和更低的死亡率（16%对51%，P<0.001）。症状性脑出血的发生率无显著差异（6%对4%，P = 0.715）。
结论
该研究表明静脉rtPA治疗对急性MCA大面积梗死患者有益且安全。
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