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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Low Alberta Stroke Program Early Computed Tomography Score within 3 Hours of Onset Predicts Subsequent Symptomatic Intracranial Hemorrhage in Patients Treated with 0.6 mg/kg Alteplase
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Low Alberta Stroke Program Early Computed Tomography Score within 3 Hours of Onset Predicts Subsequent Symptomatic Intracranial Hemorrhage in Patients Treated with 0.6 mg/kg Alteplase

机译：低alberta行程计划早期计算的断层扫描评分在发病3小时内预测随后用0.6mg / kg alteplase治疗的患者的随后症状颅内出血

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Background: The significance of early ischemic changes (EICs) on computed tomography (CT) in selecting candidates for thrombolysis remains controversial. The Alberta Stroke Program Early CT Score (ASPECTS) provides a semiquantitative scale that scores EICs within the middle cerebral artery territory using a 10-point grading system. We examined whether ASPECTS can predict the response to intravenous thrombolysis within 3 hours of stroke onset and incidence of secondary hemorrhage. Methods: Data from the Japan Alteplase Clinical Trial (J-ACT), in which 103 patients were included, were evaluated to assess the efficacy and safety of 0.6 mg/kg alteplase within 3 hours. All CT hardcopies were reevaluated retrospectively using the ASPECTS system. Multivariate logistic regression analysis was undertaken to determine whether an effect of ASPECTS existed on a defined favorable outcome as 0 or 1 on the modified Rankin Scale at 3 months, and symptomatic intracranial hemorrhage (sICH) within 36 hours. Results: The median ASPECTS value was 10 (range 3 to 10), and 56.3% revealed no evidence of EICs. ASPECTS had no effect on the patients' outcome, although a higher age and National Institutes of Health Stroke Scale score were negatively associated with a favorable outcome. On the other hand, lower ASPECTS was significantly associated with sICH (odds ratio [OR] 2.224; 95% confidence interval [CI] 1.227-4.032; P = .0084) and systolic blood pressure (OR 1.090; 95% CI 1.007-1.180; P = .0323) and the pre-ictal use of antiplatelet medications (OR 15.551; 95% CI 1.144-211.374; P = .0393). Conclusions: In J-ACT, patients with low ASPECTS values have an increased risk of thrombolysis-related sICH.
机译：背景：在选择溶栓溶解的计算机断层扫描（CT）上的早期缺血变化（EICS）的意义仍存在争议。 Alberta Stroke计划早期CT得分（方面）提供了一种使用10分层系统分解中脑动脉区域内的EICS的半定量标度。我们检查了各方面是否可以预测静脉内溶栓在卒中发病的3小时内对静脉内溶栓的反应和次要出血的发生率。方法：来自日本Alteplase临床试验（J-ACT）的数据，其中包括103名患者，评估在3小时内评估0.6mg / kg alteplase的功效和安全性。所有CT硬拷贝都被重新评估使用该方面系统重新评估。进行多元逻辑回归分析，以确定各方面是否存在于在3个月内改性的Rankin规模的0或1的效果，以及36小时内的症状颅内出血（SICH）。结果：中位数方面值为10（范围3至10），56.3％没有显示出EIC的证据。方面对患者的结果没有影响，尽管更高的年龄和国家卫生卒中量表得分与有利的结果负相关。另一方面，较低的方面与SICH显着相关（差距[或] 2.224; 95％置信区间[CI] 1.227-4.032; P = .0084）和收缩压（或1.090; 95％CI 1.007-1.180 ; p = .0323）和抗血小线涂层药物的预思素使用（或15.551; 95％CI 1.144-211.374; p = .0393）。结论：在J-ACT中，低方面值的患者具有增加的溶栓相关的SICH风险。

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