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Hyperdense artery sign, symptomatic infarct swelling and effect of alteplase in acute ischaemic stroke

Stroke & Vascular Neurology 2021年第2期6卷 238-243页

作者： Simiao Wu Grant Mair Geoff Cohen Zoe Morris Anders von Heijne Nick Bradey Lesley Cala Andre Peeters andrew j.farrall Alessandro Adami Gillian Potter Ming Liu Richard I Lindley Peter A G Sandercock joanna M Wardlaw the IST-3 Collaborative Group Department of Neurology West China HospitalSichuan UniversityChengduSichuanChina Centre for Clinical Brain Sciences The University of EdinburghEdinburghUK Department of Clinical Sciences Danderyd HospitalStockholmSweden Neuroradiology James Cook University HospitalSouth Tees Hospital NHS TrustMiddlesbroughUK Division of Pathology and Laboratory Medicine School of MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia Department of Neurology Cliniques universitaires Saint-LucBruxellesBelgium Stroke Center IRCCS Sacro Cuore Don CalabriaVeronaItaly Department of Neuroradiology Manchester Centre for Clinical NeurosciencesSalford Royal NHS Foundation TrustSalfordUK Westmead Applied Research Centre Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia The George Institute for Global Health NewtownNew South WalesAustralia UK Dementia Research Institute Centre at the University of Edinburgh EdinburghUnited Kingdom 不详

Background Alteplase improves functional outcomes of patients with acute ischaemic stroke,but its effects on symptomatic infarct swelling,an adverse complication of stroke and the influence of CT hyperdense artery sign(HAS)are *** substudy of the Third International Stroke Trial aimed to investigate the association between HAS and symptomatic infarct swelling and effect of intravenous alteplase on this *** We included stroke patients whose prerandomisation scan was non-contrast ***,masked to clinical information,assessed baseline(prerandomisation)and follow-up(24-48 hours postrandomisation)CT scans for HAS,defined as an intracranial artery appearing denser than contralateral *** infarct swelling was defined as clinically significant neurological deterioration≤7 days after stroke with radiological evidence of midline shift,effacement of basal cisterns or uncal *** Among 2961 patients,HAS presence at baseline was associated with higher risk of symptomatic infarct swelling(OR 2.21;95% CI 1.42 to 3.44).Alteplase increased the risk of swelling(OR 1.69;95% CI 1.11 to 2.57),with no difference between patients with and those without baseline HAS(p=0.49).In patients with baseline HAS,alteplase reduced the proportion with HAS at follow-up(OR 0.67;95% CI 0.50 to 0.91),where HAS disappearance was associated with reduced risk of swelling(OR 0.25,95% CI 0.14 to 0.47).Conclusion Although alteplase was associated with increased risk of symptomatic infarct swelling in patients with or without baseline HAS,it was also associated with accelerated clearance of HAS,which in return reduced swelling,providing further mechanistic insights to underpin the benefits of alteplase.

关键词： infarct swelling effect

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胆固醇酯转移蛋白基因的蛋白质截断型变异体与冠状动脉性心脏病风险的关系

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中华高血压杂志 2017年第9期25卷 899-899页

作者： Nomura A Won HH Khera AV Takeuchi F Ito K McCarthy S Emdin CA Klarin D Natarajan P Zekavat SM Gupta N Peloso GM Borecki IB Teslovich TM Asselta R Duga S Merlini PA Correa A Kessler T Wilson jG Bown Mj Hall AS Braund PS Carey Dj Murray MF Kirchner HL Leader jB Lavage DR Manus jN Hartze DN Samani Nj Schunkert H Marrugat j Elosua R McPherson R farrall M Watkins H juang jj Hsiung CA Lin SY Wang jS Tada H Kawashiri MA Inazu A Yamagishi M Katsuya T Nakashima E Nakatochi M Yamamoto K Yokota M Momozawa Y Rotter jI Lander ES Rader Dj Danesh j Ardissino D Gabriel S Willer Cj Abecasis GR Saleheen D Kubo M Kato N Ida Chen YD Dewey FE Kathiresan S 刘莉叶鹏

随机对照试验结果表明,抑制胆固醇酯转运蛋白（cholesteryl ester transfer protein,CETP）的疗法并不能降低冠状动脉性心脏病（coronary heart disease,CHD）的发生风险。研究失败的可能原因包括靶目标无效、靶目标外小分子的不良反应... 详细信息

随机对照试验结果表明,抑制胆固醇酯转运蛋白（cholesteryl ester transfer protein,CETP）的疗法并不能降低冠状动脉性心脏病（coronary heart disease,CHD）的发生风险。研究失败的可能原因包括靶目标无效、靶目标外小分子的不良反应和随机对照设计因素影响等。在编码药物靶点的基因中具有天然存在的遗传变异,以此为基础,人类研究可以深入了解针对基因产物的治疗的潜在功效和安全性。

关键词：冠状动脉性心脏病胆固醇酯转运蛋白蛋白基因发生风险蛋白质截断变异体随机对照试验 protein

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