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WSC 2014：早期溶栓降卒中后残疾发生率

2014-12-04 高晓方 译 医学论坛网

早期溶栓治疗卒中残疾发生率
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第9届世界卒中大会(WSC)的一项报告表明，急性缺血性卒中起病4.5小时内应用tPA可升高早期死亡风险，但亦可改善无显著残疾存活概率，并有可能降低远期死亡率。 此项荟萃分析共纳入包括6756例卒中患者的9项试验，并评估tPA治疗延迟对卒中转归的影响，以及tPA对症状性颅内出血风险的影响。主要有效性终点为3～6个月时mRS评分为0或1的患者比率。 结果显示，起病后1小时治疗与mRS

第9届世界卒中大会(WSC)的一项报告表明，急性缺血性卒中起病4.5小时内应用tPA可升高早期死亡风险，但亦可改善无显著残疾存活概率，并有可能降低远期死亡率。

此项荟萃分析共纳入包括6756例卒中患者的9项试验，并评估tPA治疗延迟对卒中转归的影响，以及tPA对症状性颅内出血风险的影响。主要有效性终点为3～6个月时mRS评分为0或1的患者比率。

结果显示，起病后1小时治疗与mRS 0或1的比指标为1.85具有相关性，5小时治疗则比值比降低至1.2。尽管tPA可增加颅内出血死亡早期风险，但tPA早期治疗在患者转归方面的获益更大。卒中起病后4.5个小时内应用tPA可增加无显著残疾存活机率。

美国辛辛那提大学Broderick教授表示，在卒中起病5小时后应用tPA可能会丧失其对转归的积极影响，并可能导致死亡轻度增多。目前仍有待明确的问题是在此时间窗外是否存在可从tPA治疗获益的亚组患者。

原始出处：

Daniel M. Keller, Early Thrombolysis Reduces Post-stroke Disability,Medscape Medical News  November 11, 2014


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1826268, encodeId=947918262681d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Oct 01 23:35:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671184, encodeId=0a5716e118456, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sun Nov 15 18:35:00 CST 2015, time=2015-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13229, encodeId=664113229de, content=溶栓越早越好, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=870092288, createdName=rosa00tong, createdTime=Fri Dec 19 05:44:00 CST 2014, time=2014-12-19, status=1, ipAttribution=)]
    2015-10-01 一叶知秋

    #发生率#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1826268, encodeId=947918262681d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Oct 01 23:35:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671184, encodeId=0a5716e118456, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sun Nov 15 18:35:00 CST 2015, time=2015-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13229, encodeId=664113229de, content=溶栓越早越好, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=870092288, createdName=rosa00tong, createdTime=Fri Dec 19 05:44:00 CST 2014, time=2014-12-19, status=1, ipAttribution=)]
    2015-11-15 waiwai3039

    #卒中后#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1826268, encodeId=947918262681d, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Oct 01 23:35:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671184, encodeId=0a5716e118456, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sun Nov 15 18:35:00 CST 2015, time=2015-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13229, encodeId=664113229de, content=溶栓越早越好, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=870092288, createdName=rosa00tong, createdTime=Fri Dec 19 05:44:00 CST 2014, time=2014-12-19, status=1, ipAttribution=)]
    2014-12-19 rosa00tong

    溶栓越早越好

    0

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