Cheong Edmund, Dodd Lizzie, Smith William, Kleinig Timothy
Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
J Stroke Cerebrovasc Dis. 2018 Feb;27(2):e36-e37. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.039. Epub 2017 Oct 31.
Severe orolingual angioedema is a life-threatening complication of alteplase treatment for acute ischemic stroke that occurs during alteplase infusion or in the first 2 hours afterward. Currently, there are no proven therapies, although glucocorticoids, antihistamines, and adrenaline are sometimes used. Intubation is required if significant airway compromise supervenes. The incidence is .2%-5.1%, and risk factors include treatment with angiotensin-converting enzyme inhibitors and total insular infarcts. Here we report a case of alteplase-induced severe angioedema, which resolved briskly following icatibant treatment.
严重口咽血管性水肿是急性缺血性卒中阿替普酶治疗的一种危及生命的并发症，发生于阿替普酶输注期间或之后的2小时内。目前，尚无经证实的治疗方法，尽管有时会使用糖皮质激素、抗组胺药和肾上腺素。如果出现严重气道受压，则需要插管。发病率为0.2% - 5.1%，危险因素包括使用血管紧张素转换酶抑制剂治疗和岛叶完全梗死。我们在此报告1例阿替普酶诱导的严重血管性水肿病例，该病例在接受依卡替班治疗后迅速缓解。
