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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Thromboelastographic changes in patients experiencing an acute ischemic stroke and receiving alteplase
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Thromboelastographic changes in patients experiencing an acute ischemic stroke and receiving alteplase

机译：发生急性缺血性中风并接受阿替普酶的患者的血栓弹力图变化

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Background Thromboelastography is a method of measuring whole-blood coagulation changes and has been used to guide therapy and monitor changes in a variety of disease states. However, few studies have investigated the thromboelastographic changes experienced in a patient who has received alteplase for an acute ischemic stroke. This pilot study sought to describe the effect of alteplase on the thromboelastogram tracings of patients experiencing an acute ischemic stroke. Methods This was an institutional review board-approved prospective cohort study. Patients who presented to the emergency department with symptoms of acute ischemic stroke and received intravenous alteplase were evaluated for inclusion. Blood samples were obtained before alteplase administration and at 30, 60, 90, 120, and 150 minutes after alteplase administration. In addition, baseline variables collected included patient age, sex, prothrombin time, partial thromboplastin time, and the use of pretreatment anticoagulants or antiplatelet agents. Patients were also followed throughout their hospital stay for development of intracranial hemorrhage. Results A total of 7 patients were included in the analysis. At baseline, thromboelastogram parameters of all patients were within the normal range. The maximum inhibition of fibrin buildup was seen at 30 minutes after the start of alteplase infusion, and the lowest clot strength was observed at 60 minutes after initiation of alteplase. Most patients return to near baseline parameters within 150 minutes of alteplase initiation; however, 2 patients did not return to their baseline values within the 150-minute time frame. Conclusions Our study suggests that thromboelastogram (TEG) is a useful tool for determining changes in the coagulation system of patients whom have received recombinant tissue plasminogen activator (rt-PA). Further study is needed to determine if TEG can be used to predict those patients who may be at higher risk of adverse events because of rt-PA.
机译：背景血栓弹力图是一种测量全血凝固变化的方法，已被用于指导治疗和监测各种疾病状态的变化。但是，很少有研究调查接受阿替普酶治疗的急性缺血性卒中患者的血栓弹力图变化。这项初步研究试图描述阿替普酶对经历急性缺血性中风的患者血栓弹力图描记的影响。方法这是一项经过机构审查委员会批准的前瞻性队列研究。对急诊科出现急性缺血性中风症状并接受静脉阿替普酶治疗的患者进行评估纳入。在给予阿替普酶之前以及在给予阿替普酶之后30、60、90、120和150分钟获得血液样品。此外，收集的基线变量包括患者年龄，性别，凝血酶原时间，部分凝血活酶时间以及使用预处理抗凝药或抗血小板药。在整个住院期间都对患者进行了随访，以了解颅内出血的发生情况。结果分析共纳入7例患者。在基线时，所有患者的血栓弹力图参数均在正常范围内。在开始阿替普酶输注后30分钟观察到最大的纤维蛋白堆积抑制作用，而在开始阿替普酶后60分钟观察到最低的凝块强度。大多数患者在开始使用阿替普酶后的150分钟内恢复到接近基线的参数。但是，有2名患者在150分钟内未恢复到基线值。结论我们的研究表明血栓弹力图（TEG）是确定接受重组组织纤溶酶原激活剂（rt-PA）的患者凝血系统变化的有用工具。需要进一步研究以确定TEG是否可用于预测那些因rt-PA而处于较高不良事件风险中的患者。

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