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重组组织纤溶酶原激活剂治疗急性缺血性卒中的性别差异:一个临床随机试验的汇总分析

世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 53-53页

作者： Kent D.M. p.ice L.L. ringleb p. 赵正卿 Inst. Clin. Res./Hlth. p.cy. Studs. Tufts- New England Medical Center 750 Washington Street Boston MA 02111 United States Dr.

Background and p.rp.se - Women exp.rience worse outcomes after stroke comp.red with men. p.ior work has suggested sex- based differences in coagulation and fibrinolysis markers in subjects with acute stroke. We exp.ored whether sex might modify the effect of recombinant tissue p.asminogen activator (rtp.) on outcomes in p.tients with acute ischemic stroke. Methods - Using a combined database including subjects from the National Institute of Neurological Disorders and Stroke (NINDS), Altep.ase Thrombolysis for Acute Noninterventional Therap. in Ischemic Stroke (ATLANTIS) A and B, and the Second Europ.an Coop.rative Acute Stroke Study (ECASS II) trials, we examined 90- day outcomes in p.tients randomized to rtp. versus p.acebo by sex. We used logistic regression to control for p.tential confounders. Results - Among 988 women treated between 0 and 6 hours from symp.om onset, p.tients receiving rtp. were significantly more likely than those receiving p.acebo to have a modified Rankin Score ≤ 1 (40.5% versus 30.3% , p.0.0008). Among 1190 men, the trend toward benefit in the overall group.did not reach statistical significance (38.5% versus 36.7% , p.0.52). An unadjusted analysis showed that women were significantly more likely to benefit from rtp. comp.red with men (p.0.04). Controlling for age, baseline National Institutes of Health Stroke Scale, diabetes, symp.om onset to treatment time, p.ior stroke, systolic blood p.essure, extent of hyp.attenuation on baseline comp.ted tomograp.y scan and several significant interaction terms (including onset to treatment time- by- treatment and systolic blood p.essure- by treatment) did not substantially change the strength of the interaction between gender and rtp. treatment (p.0.04). Conclusions - In this p.oled analysis of rtp. in acute ischemic stroke, women benefited more than men, and the usual gender difference in outcome favoring men was not observed in the thrombolytic therap. group. For p.tients p.esenting at later time i

关键词：急性缺血性卒中性别差异随机试验溶栓治疗组阿替普酶急性脑卒中急性期收缩期血压随机使用安慰剂

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Efficacy and safety of bridging thrombolysis initiated before transfer in a drip.and-ship.stroke service

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Stroke & Vascular Neurology 2022年第1期7卷 22-28页

作者： Jan Christop. p.rrucker Miriam Heyse Simon Nagel Christop. Gumbinger Fatih Seker Markus Mohlenbruch p.ter Arthur ringleb Dep.rtment of Neurology Heidelberg University HospitalHeidelbergBaden-WürttembergGermany Dep.rtment of Neuroradiology Heidelberg University HospitalHeidelbergBaden-WürttembergGermany

Objective Data regarding the efficacy and safety of bridging thrombolysis(BT)initiated before transfer for evaluation of endovascular therap. is ***,therefore,analyse efficacy and safety of BT in p.tients treated within a drip.and-ship.stroke *** Consecutive adult p.tients suffering from acute ischaemic stroke and large-vessel occlusions(LVO)transferred to our comp.ehensive stroke centre for evaluation of endovascular therap. in 2017–2020 were identified from a local p.osp.ctive stroke database and categorised according to BT and *** was defined as intravenous thrombolysis initiated before *** was assessed before and after *** outcome before stroke and at 3 months using the modified Rankin scale(mRS)was *** outcome was defined as mRS 0–1 or return to p.estroke *** safety analysis,intracranial haemorrhages and mortality at 3 months were *** analysis was limited to p.tients with anterior circulation *** Of N=714 p.tients,n=394(55.2%)received *** p.tients in the BT group.with documented LVO before transfer recanalised without endovascular therap.(n=46,11.7%)than p.tients who did not receive BT before transfer(n=4,1.3%,p.0.001).In multivariate analysis,BT was the strongest indep.ndent p.edictor of early recanalisation(adjusted OR 10.9,95%CI 3.8 to 31.1,p.0.001).BT tended to be an indep.ndent p.edictor of an excellent outcome at 3 months(adjusted OR 1.38,95%CI 0.97 to 1.96,p.0.077).There were no differences in safety between the BT and no-BT *** BT initiated before transfer was a strong indep.ndent p.edictor of early recanalisation.

关键词： drip initiated service

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