Neurology：卒中前认知损害或不影响缺血性卒中患者rtPA溶栓治疗

2014-05-19 cath 编译医学论坛网

一项多国联合研究表明，卒中前认知损害(PSCI)的缺血性卒中患者如果符合条件，应该接受重组组织型纤溶酶原激活剂(rtPA)治疗;但不能扩展到严重认知损害或严重卒中患者。该研究为存在PSCI的急性缺血性卒中患者接受IV rtPA 治疗可改善其预后提供了IV级证据。相关论文5月14日在线发表于《神经病学》(Neurology)杂志。该多中心前瞻性观察研究名为“OPHELIE-COG”，旨在探讨接受

一项多国联合研究表明，卒中前认知损害(PSCI)的缺血性卒中患者如果符合条件，应该接受重组组织型纤溶酶原激活剂(rtPA)治疗;但不能扩展到严重认知损害或严重卒中患者。该研究为存在PSCI的急性缺血性卒中患者接受IV rtPA 治疗可改善其预后提供了IV级证据。相关论文5月14日在线发表于《神经病学》(Neurology)杂志。

该多中心前瞻性观察研究名为“OPHELIE-COG”，旨在探讨接受rtPA治疗的卒中患者PSCI对其转归的影响。共纳入205例接受静脉注射(IV)rtPA治疗的法国和日本缺血性卒中患者。在老年人群中通过认知问卷简短版调查评估先前的认知状态。以平均分数>3定义为PSCI。主要终点为3个月后良好转归[改良Rankin量表(mRS)0–1分]。次要终点为3个月后症状性颅内出血(sICH)、mRS评分0–2和死亡率。

结果显示，62例患者(30.2%)符合PSCI标准，他们年龄偏大11岁。虽然这些患者3个月后更多的发生sICH，且较少能独立活动，但在校正年龄、基线其NIH卒中量表评分和发病至进针时间后，患者的任一终点无差异;sICH、mRS 0–1、mRS 0–2和死亡的比值比(OR)分别为2.78、0.82、0.62和0.40。汇集分析显示，PSCI与任何终点均无相关性。

原始出处：

Murao K1, Leys D2, Jacquin A1, Kitazono T1, Bordet R1, Béjot Y1, Kimura K1, Godefroy O1, Wakisaka Y1, Moulin S1, Ago T1, Sibon I1, Bombois S1, Mas JL1, Hénon H1, Pasquier F1, Giroud M1, Cordonnier C1, Okada Y1; On behalf of the OPHELIE-COG investigators.Thrombolytic therapy for stroke in patients with preexisting cognitive impairment.Neurology. 2014 May 14. pii: 10.1212/WNL.0000000000000493. [Epub ahead of print]

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2014-11-26 wangyang7969

#卒中患者#

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2014-12-01 yinhl1978

#Neurol#

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2014-06-11 ms3117646317107274

#rtPA#

31 0
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2014-06-11 wjywjy

#缺血性卒中患者#

24 0
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2014-07-07 循证小兵

#tPA#

29 0
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2014-05-31 仁心济世

#tPA溶栓#

43 0
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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Tue May 20 17:24:00 CST 2014, time=2014-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892611, encodeId=23c9189261160, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Apr 14 10:24:00 CST 2015, time=2015-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1418528, encodeId=8634141852802, content=<a href='/topic/show?id=b88266482f7' target=_blank style='color:#2F92EE;'>#溶栓治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66482, encryptionId=b88266482f7, topicName=溶栓治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00673387794, createdName=lqvr, createdTime=Wed May 21 04:24:00 CST 2014, time=2014-05-21, status=1, ipAttribution=)]
2014-05-20 12498da4m32(暂无昵称)

#缺血性卒#

29 0
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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66482, encryptionId=b88266482f7, topicName=溶栓治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00673387794, createdName=lqvr, createdTime=Wed May 21 04:24:00 CST 2014, time=2014-05-21, status=1, ipAttribution=)]
2015-04-14 guihongzh

#缺血性#

22 0
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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66482, encryptionId=b88266482f7, topicName=溶栓治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00673387794, createdName=lqvr, createdTime=Wed May 21 04:24:00 CST 2014, time=2014-05-21, status=1, ipAttribution=)]
2014-05-21 lqvr

#溶栓治疗#

0 0

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Neurology：卒中前认知损害或不影响缺血性卒中患者rtPA溶栓治疗

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