Jiang Xinzhao, Yuan Ruozhen, Ye Jiawei, Wang Xu, Shi Zongjie, Guo Shunyuan
Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Hangzhou Medical College, School of Basic Medical Sciences and Forensic Medicine, Hangzhou, China.
Sci Rep. 2025 Jan 11;15(1):1685. doi: 10.1038/s41598-025-85969-1.
To evaluate the safety and efficacy of dual antiplatelet therapy (DAPT) versus tenecteplase in minor non-disabling acute ischemic stroke. This retrospective observational study utilized data from our stroke database. All consecutive patients with minor non-disabling acute ischemic stroke treated with either DAPT or tenecteplase between January 2020 and June 2023 were included in the analysis. Of the 62 patients included in the analysis, the median (IQR) age was 66 (58-76) years, and 21 patients (34%) were female. Compared with patients receiving DAPT, those treated with tenecteplase were had higher NIHSS score at treatment (median [IQR], 4 [2-5] vs. 1 [1-2]; P = 0.01). At 90 days, 74.2% of patients (23/31) in the DAPT group and 71.0% (22/31) in the tenecteplase group had an excellent functional outcome (P = 0.78). Lower proportion of patients with minor bleeding events in DAPT group than tenecteplase group (3.2% [1/31] vs. 25.8% [8/31], P = 0.01). The findings in this study show that patients presenting with minor nondisabling acute ischemic stroke within 4.5 h of symptom onset, dual antiplatelet treatment was similar to intravenous tenecteplase with regard to excellent functional outcome at 90 days. However, more proportion of patients with bleeding events treated with tenecteplase.
评估双抗血小板治疗（DAPT）与替奈普酶治疗轻度非致残性急性缺血性卒中的安全性和有效性。这项回顾性观察研究使用了我们卒中数据库中的数据。分析纳入了2020年1月至2023年6月期间接受DAPT或替奈普酶治疗的所有连续性轻度非致残性急性缺血性卒中患者。在纳入分析的62例患者中，年龄中位数（四分位间距）为66（58 - 76）岁，21例患者（34%）为女性。与接受DAPT的患者相比，接受替奈普酶治疗的患者在治疗时美国国立卫生研究院卒中量表（NIHSS）评分更高（中位数[四分位间距]，4[2 - 5] vs. 1[1 - 2]；P = 0.01）。在90天时，DAPT组74.2%（23/31）的患者和替奈普酶组71.0%（22/31）的患者获得了良好的功能结局（P = 0.78）。DAPT组发生轻微出血事件的患者比例低于替奈普酶组（3.2%[1/31] vs. 25.8%[8/31]，P = 0.01）。本研究结果表明，对于症状发作4.5小时内出现轻度非致残性急性缺血性卒中的患者，在90天时双抗血小板治疗与静脉注射替奈普酶在获得良好功能结局方面相似。然而，接受替奈普酶治疗的患者发生出血事件的比例更高。
