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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Feasibility and safety of intravenous thrombolysis in multiethnic Asian stroke patients in Singapore.
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Feasibility and safety of intravenous thrombolysis in multiethnic Asian stroke patients in Singapore.

机译：新加坡多族裔亚洲中风患者进行静脉溶栓治疗的可行性和安全性。

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Treatment rates with intravenously administered tissue plasminogen activator (IV-tPA) in acute ischemic stroke (IS) remain low in Asian populations. Various logistic obstacles and higher anticipated bleeding risk in Asians are major concerns. We report on the feasibility and safety of IV-tPA therapy at our tertiary care center. Consecutive acute IS patients eligible for thrombolysis were treated with low-dose (maximum 50 mg) IV-tPA between January 2000 and September 2006 and with standard-dose (maximum 90 mg) IV-tPA between October 2006 and May 2008. The efficacy of IV-tPA was assessed by the modified Rankin Scale (mRS) score at 3 months and by absolute changes in the National Institute of Health Stroke Scale (NIHSS) score at hospital discharge and 3 months. The safety of IV-tPA was assessed by the rate of symptomatic intracranial hemorrhage (SICH). A total of 130 patients were included (mean age, 60+/-13 years; 60% males; median NIHSS score, 14). A total of 48 patients received low-dose IV-tPA, and 82 patients received standard-dose IV-tPA. The median onset to treatment time was 160 minutes. Some 59% of the patients achieved functional independence (mRS score 0-1) at 3 months with standard-dose tPA, compared with 35% in the low-dose group (P=.011). SICH occurred more frequently with the low dose (14.5%) than with the standard dose (1.2%; P=.004). In a multivariate logistic regression model, lower admission NIHSS score (odds ratio [OR]=0.78 per 1-point increase; 95% confidence interval [CI]=0.70-0.88), lower pretreatment blood glucose level (OR=0.76 per 1 mmol/L increase; 95% CI=0.60-0.95), shorter time from symptom onset to IV-tPA bolus (OR=0.97 per 1-minute increase; 95% CI=0.94-1.0), and standard-dose IV-tPA (OR=12.49; 95% CI=2.9-53.89) were associated with a higher likelihood for functional independence at 3 months. Our data indicate that standard-dose IV-tPA (0.9 mg/kg) was feasible and safe for treating acute IS in our multiethnic Asian population in Singapore.
机译：在亚洲人群中，静脉注射组织纤溶酶原激活剂（IV-tPA）治疗急性缺血性中风（IS）的比率仍然很低。主要的担忧是亚洲人的各种后勤障碍和更高的出血风险。我们在我们的三级护理中心报告了IV-tPA治疗的可行性和安全性。在2000年1月至2006年9月期间，连续接受符合溶栓作用的急性IS患者接受低剂量（最大50毫克）IV-tPA治疗，并于2006年10月至2008年5月之间接受标准剂量（最大90毫克）IV-tPA治疗。通过修改后的3个月的Rankin量表（mRS）评分以及出院时和3个月时美国国立卫生研究院卒中量表（NIHSS）评分的绝对变化来评估IV-tPA。通过症状性颅内出血（SICH）的速度评估IV-tPA的安全性。总共包括130名患者（平均年龄为60 +/- 13岁;男性为60％; NIHSS中位数为14）。共有48例患者接受低剂量IV-tPA，82例患者接受标准剂量IV-tPA。治疗时间的中位数为160分钟。约59％的患者在使用标准剂量tPA的3个月时达到了功能独立性（mRS评分0-1），而低剂量组为35％（P = .011）。低剂量（14.5％）发生SICH的频率高于标准剂量（1.2％; P = .004）。在多元Logistic回归模型中，入院NIHSS得分较低（赔率[OR] = 0.78每增加1分; 95％置信区间[CI] = 0.70-0.88），较低的治疗前血糖水平（OR = 0.76每1 mmol / L增加; 95％CI = 0.60-0.95），从症状发作到静脉给予tPA推注的时间更短（每1分钟增加OR = 0.97; 95％CI = 0.94-1.0）和标准剂量IV-tPA（ OR = 12.49; 95％CI = 2.9-53.89）与3个月时功能独立的可能性更高。我们的数据表明，在新加坡的多种族亚洲人群中，标准剂量的IV-tPA（0.9 mg / kg）对于治疗急性IS是可行且安全的。

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