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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Defining Mild Stroke: Outcomes Analysis of Treated and Untreated Mild Stroke Patients
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Defining Mild Stroke: Outcomes Analysis of Treated and Untreated Mild Stroke Patients

机译：定义轻度中风：治疗和未治疗轻度中风患者的结果分析

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Background: Mild deficit is a relative contraindication to administration of intravenous recombinant tissue plasminogen activator (IV rtPA) for acute ischemic stroke. However, what constitutes "mild'' deficit is vague. Prior studies showed patients with mild strokes have substantial disability rates at hospital discharge and at 90 days. We investigated whether the application of a new definition altered the rates of disability overall and assessed the effects of thrombolysis. Methods: This analysis included all adult acute ischemic stroke patients from a prospective registry of consecutive patients (University of California San Diego Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) database, 2003-2014) with 90-day modified Rankin Scale (mRS) score available who were defined as "mild'' using either: National Institutes of Health Stroke Scale (NIHSS) 0-5 or a "Re-examining Acute Eligibility for Thrombolysis'' (TREAT) Task Force definition (NIHSS 0-5 and nondisabling based on prespecified syndromes). Dichotomized 90-day mRS were compared between treated and untreated patients using the 2 definitions. Results: Of 802 ischemic stroke patients with mRS scores available, 184 had baseline mRS (0) and met TREAT criteria; 45 (24.5%) were rtPA treated. Among the treated patients, 35.6% had 90-day mRS (2-6), versus 28.8% in the untreated group, a nonsignificant difference after adjusting for baseline NIHSS (P = .47). None of the 45 treated patients had symptomatic hemorrhage. Outcomes were similar using the simpler NIHSS 0-5 definition. Conclusions: About one third of mild stroke patients were not functionally independent at 90 days, irrespective of treatment or mild definition applied, calling into question the treatment efficacy of IV rtPA for mild strokes and what constitutes an appropriate definition of "mild.'' Randomized studies are necessary to determine rtPA treatment efficacy in mild stroke patients.
机译：背景：轻度缺乏症是急性缺血性中风的静脉注射重组组织纤溶酶原激活剂（IV rtPA）的相对禁忌症。然而，“轻度”缺陷的构成是模糊的，以前的研究表明轻度中风患者在出院时和90天时有相当大的残疾率，我们调查了新定义的应用是否改变了总体残疾率并评估了效果方法：该分析包括来自连续患者的前瞻性登记册（加利福尼亚大学圣地亚哥分校急性卒中转化研究专业计划（SPOTRIAS）数据库，2003-2014年）和90天改良兰金的所有成年急性缺血性中风患者。现有的量表（mRS）得分被定义为“轻度”，使用以下两种方法之一：国立卫生研究院中风量表（NIHSS）0-5或“重新检查急性溶栓的资格”（TREAT）工作组定义（NIHSS 0 -5和基于预先确定的综合症的非残疾），使用这两种定义比较了治疗和未治疗患者的两天90天mRS结果：802例缺血性具有mRS评分的前瞻性患者，有184例基线mRS（0）并符合TREAT标准; rtPA治疗了45（24.5％）。在接受治疗的患者中，有35.6％的患者具有90天的mRS（2-6），而未治疗的患者为28.8％，校正基线NIHSS后差异无统计学意义（P = 0.47）。 45名接受治疗的患者均未出现症状性出血。使用较简单的NIHSS 0-5定义，结果相似。结论：约三分之一的轻度中风患者在90天时没有功能独立性，无论采用何种治疗或轻度定义，都对IV rtPA对轻度中风的治疗效果以及“轻度”的适当定义提出了疑问。研究对于确定轻度卒中患者的rtPA治疗疗效是必要的。

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