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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke
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Even Faster Door-to-Alteplase Times and Associated Outcomes in Acute Ischemic Stroke

机译：甚至更快的急性缺血性卒中中的门到异酶次数和相关的结果

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Background and Purpose: The timely administration of thrombolytic therapy for acute ischemic stroke has been associated with good functional outcomes. Current guidelines recommend alteplase administration within 60 minutes in 75% of eligible patients and within 45 minutes in 50% of patients. There is limited evidence guiding these measures and their effect on outcomes. We report a single-center, retrospective assessment of the safety and efficacy of alteplase treatment within 45 minutes. Methods: Five hundred and eighty-six patients were treated with alteplase in our emergency departments (EDs) between January 2014 and October 2016; 368 patients were included for analysis. Multivariate regression analysis was used to assess the association between door-to-alteplase (DTA) times and 90-day modified Rankin scale (mRS) scores. Incidence of intracerebral hemorrhage (ICH) was also documented. Results: The median DTA time was 29 minutes versus 64 minutes in the DTA less than or equal to 45 minutes arm and more than 45 minutes arm, respectively. The primary outcome of 90-day mRS 0-1 was achieved in 56% of patients in the less than or equal to 45 minutes group versus 58% in more than 45 minutes group (P = .67). Odds of achieving mRS 0-1 were not significantly impacted by DTA times. In the multivariate regression analysis, patient characteristics associated with achieving mRS 0-1 were: younger age, male sex, not requiring intubation in the ED, and without prior history of hypertension, atrial fibrillation, or stroke. There was no significant difference in rates of ICH for patients less than or equal to 45 minutes versus more than 45 minutes. Conclusions: Rapid administration of alteplase was not associated with significantly better outcomes nor increased risk of ICH. Conclusions about efficacy are limited due to the retrospective nature of the study, small sample size, and incomplete data points.
机译：背景论：及时施用急性缺血性卒中的溶栓治疗已经与良好的功能结果有关。目前的指导方针建议在75％的符合条件患者的60分钟内提出了Alteplase管理，在50％的患者中45分钟内。有限的证据引导了这些措施及其对结果的影响。我们报告了一个中心，回顾性评估了45分钟内的Alteplase治疗的安全性和疗效。方法：在2014年1月至2016年1月至10月期间，在我们的急诊部门（EDS）中将五百八十六名患者用Alteplase治疗; 368名患者被包括分析。多变量回归分析用于评估门 - 叠酶（DTA）次（DTA）次的关联和90天改进的Rankin规模（MRS）评分。还记录了脑出血（ICH）的发病率。结果：中位数DTA时间为29分钟，DTA的64分钟分别小于或等于45分钟和超过45分钟的臂。 90天MRS 0-1的主要结果是在56％的患者中达到45分钟组，而超过45分钟的组（P = .67）。达到0-1夫人的几率没有受到DTA次的显着影响。在多元回归分析中，与达到0-1夫人相关的患者特征是：较年轻的年龄，男性，不需要在ED中插管，而没有高血压，心房颤动或中风历史。对于超过45分钟的患者而言，患者的ICH率没有显着差异。结论：快速施用异液酶与明显更好的结果也不有关，也不会增加ICH的风险。关于疗效的结论是有限的，因为研究的回顾性，小样本大小和不完全数据点。

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