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抗凝治疗延迟并不影响脑静脉血栓形成的功能结局。

Anticoagulation delay does not affect the functional outcome of cerebral venous thrombosis.

机构信息

China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

出版信息

Aging (Albany NY). 2020 Jun 18;12(12):11835-11842. doi: 10.18632/aging.103353.

Abstract

Available knowledge about the impact of anticoagulation delay on outcomes of patients with cerebral venous thrombosis (CVT) is limited. We therefore assessed the factors influencing anticoagulation delay and investigated the effect of this delay on outcomes of CVT patients. Anticoagulation delay was defined as the time interval between symptom onset and anticoagulation initiation. The primary outcome was a modified Rankin Scale (mRS) score > 2 at the final follow-up. A total of 164 eligible patients were included. The median anticoagulation delay was 9 days. Cerebral hemorrhage on admission neuroimaging correlated with earlier anticoagulation (p = 0.040). Anticoagulation delay was not associated with poor functional outcome (mRS > 2), but it was associated with residual headache across the entire cohort (earlier anticoagulation: 15/76 [19.7%] vs. later anticoagulation: 28/79 [35.4%]; p = 0.029) and in the subgroup with isolated intracranial hypertension (earlier anticoagulation: 4/25 [16.0%] vs. later anticoagulation: 14/27 [51.9%]; p = 0.007). Anticoagulation delay was found to be common among patients with CVT. Anticoagulation delay was not associated with poor functional outcome, but may have led to an increased risk of residual headache across our entire cohort and in the subgroup with isolated intracranial hypertension.

摘要

关于抗凝延迟对脑静脉血栓形成(CVT)患者结局影响的现有知识有限。因此,我们评估了影响抗凝延迟的因素,并研究了这种延迟对 CVT 患者结局的影响。抗凝延迟定义为从症状发作到开始抗凝的时间间隔。主要结局是最终随访时改良 Rankin 量表(mRS)评分>2。共纳入 164 例符合条件的患者。抗凝延迟的中位数为 9 天。入院神经影像学检查显示脑出血与更早的抗凝治疗相关(p=0.040)。抗凝延迟与不良功能结局(mRS>2)无关,但与整个队列的残余头痛相关(更早抗凝:76 例中的 15 例[19.7%] vs. 较晚抗凝:79 例中的 28 例[35.4%];p=0.029),在单纯颅内高压亚组中也相关(更早抗凝:25 例中的 4 例[16.0%] vs. 较晚抗凝:27 例中的 14 例[51.9%];p=0.007)。CVT 患者的抗凝延迟较为常见。抗凝延迟与不良功能结局无关,但可能导致整个队列和单纯颅内高压亚组的残余头痛风险增加。

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本文引用的文献

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Cerebral venous thrombosis.脑静脉血栓形成。
Nat Rev Neurol. 2017 Sep;13(9):555-565. doi: 10.1038/nrneurol.2017.104. Epub 2017 Aug 18.
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