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Stroke:急性卒中入院前快速治疗获益定量评估

2015-10-18 MedSci MedSci原创

背景和目的:在急性缺血性卒中患者中,从发病到应用组织类型纤溶酶原激活物溶栓治疗的时间是预后的决定因素。为了减少OTT,已经进行临床试验评估应用移动计算机断层扫描仪进行入院前脑影像检查的收益。入院前,评估生物标志物可能区分缺血性脑卒中和脑出血患者。这种治疗措施怎么转化为临床应用尚未进行调查评估。方法:研究人员建立模型评估OTT较短的临床获益。研究人员评估患者的良好预后和平均生存年龄。结果:在卒中患者

背景和目的:在急性缺血性卒中患者中,从发病到应用组织类型纤溶酶原激活物溶栓治疗的时间是预后的决定因素。为了减少OTT,已经进行临床试验评估应用移动计算机断层扫描仪进行入院前脑影像检查的收益。入院前,评估生物标志物可能区分缺血性脑卒中和脑出血患者。这种治疗措施怎么转化为临床应用尚未进行调查评估。

方法:研究人员建立模型评估OTT较短的临床获益。研究人员评估患者的良好预后和平均生存年龄。

结果:在卒中患者中,OTT减少60分钟,良好预后的可能性增加6.6%。为了对比,组织纤溶酶原激活物本身的平均效应为7.0%。入院前移动计算机断层扫描时间提前25到40分钟,良好预后的可能性增加3.0%到4.6%。扫描发现大血管闭塞的患者直接进行血管内治疗增加良好预后的可能性增加0.2%到1.0%。在应用组织纤溶酶原激活物治疗的时间提前32或40分钟并且脑出血敏感性大于75%到80%,检查血液生物标记物区分缺血性卒中和脑内出血收益可能超过脑扫描的收益。

结论:减少OTT有利于急性卒中患者的预后。可能在许多条件下,未进行脑影像扫描而进行组织纤溶酶原激活物溶栓治疗包括,检测脑出血的敏感性大于75%到80%,时间增益大于32到40分钟。

原文出处:

Lorenz MW, Lauer A, Foerch C. Quantifying the Benefit of Prehospital Rapid Treatment in Acute Stroke: Benchmark for Future Innovative Clinical Trials. Stroke.  2015 Oct 6.

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    2016-03-02 勇敢的医生

    已读

    0

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    2015-11-17 limin0214

    翻译得不好,还是看原文吧

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2076548, encodeId=651a20e654808, content=<a href='/topic/show?id=3e5845990dc' target=_blank style='color:#2F92EE;'>#定量评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45990, encryptionId=3e5845990dc, topicName=定量评估)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed May 18 13:13:00 CST 2016, time=2016-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66934, encodeId=6053669344a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=51621695073, createdName=勇敢的医生, createdTime=Wed Mar 02 23:57:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769936, encodeId=6a061e69936b8, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Thu Mar 10 14:13:00 CST 2016, time=2016-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43306, encodeId=4ca643306bb, content=翻译得不好,还是看原文吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76271605667, createdName=limin0214, createdTime=Tue Nov 17 09:56:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284435, encodeId=88ab128443541, content=<a href='/topic/show?id=d2155222281' target=_blank style='color:#2F92EE;'>#急性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52222, encryptionId=d2155222281, topicName=急性卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa4194, createdName=cenghis, createdTime=Tue Oct 20 00:13:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39265, encodeId=b4e43926560, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:59:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39263, encodeId=b9b03926382, content=谢谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:58:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39264, encodeId=0d8039264fb, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:58:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39041, encodeId=627939041d5, content=谢谢您的分享~~~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151016/IMG56205A89715F55916.jpg, createdBy=23dd1656569, createdName=Wei Junhui, createdTime=Sun Oct 18 09:48:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 sunlong28

    为了积分我也是拼了~

    0

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    2015-10-18 sunlong28

    谢谢分享~

    0

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    2015-10-18 sunlong28

    赞一个

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2076548, encodeId=651a20e654808, content=<a href='/topic/show?id=3e5845990dc' target=_blank style='color:#2F92EE;'>#定量评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45990, encryptionId=3e5845990dc, topicName=定量评估)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed May 18 13:13:00 CST 2016, time=2016-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=66934, encodeId=6053669344a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=51621695073, createdName=勇敢的医生, createdTime=Wed Mar 02 23:57:00 CST 2016, time=2016-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769936, encodeId=6a061e69936b8, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Thu Mar 10 14:13:00 CST 2016, time=2016-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43306, encodeId=4ca643306bb, content=翻译得不好,还是看原文吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76271605667, createdName=limin0214, createdTime=Tue Nov 17 09:56:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284435, encodeId=88ab128443541, content=<a href='/topic/show?id=d2155222281' target=_blank style='color:#2F92EE;'>#急性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52222, encryptionId=d2155222281, topicName=急性卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa4194, createdName=cenghis, createdTime=Tue Oct 20 00:13:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39265, encodeId=b4e43926560, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:59:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39263, encodeId=b9b03926382, content=谢谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:58:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39264, encodeId=0d8039264fb, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Sun Oct 18 21:58:00 CST 2015, time=2015-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39041, encodeId=627939041d5, content=谢谢您的分享~~~, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151016/IMG56205A89715F55916.jpg, createdBy=23dd1656569, createdName=Wei Junhui, createdTime=Sun Oct 18 09:48:00 CST 2015, time=2015-10-18, status=1, ipAttribution=)]
    2015-10-18 Wei Junhui

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