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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >A Therapeutic International Normalized Ratio Results in Smaller Infarcts and Better Outcomes for Patients with Ischemic Stroke
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A Therapeutic International Normalized Ratio Results in Smaller Infarcts and Better Outcomes for Patients with Ischemic Stroke

机译：治疗性国际规范化比率导致缺血性卒中患者的较小梗塞和更好的结果

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Background: Prior studies have shown that warfarin is effective for both primary and secondary stroke prevention in individuals with atrial fibrillation. It is also known that those on warfarin with atrial fibrillation often have poorer long-term poststroke outcomes, possibly because cardioembolic strokes tend to be larger and more severe. Less is known regarding the direct effect of the international normalized ratio (INR) value at the time of stroke on severity or long-term functional status. Methods: We prospectively followed a consecutive series of 112 patients presenting to our institution with acute ischemic stroke between 2013 and 2018 who were on warfarin. Along with INR on admission, data were collected regarding patient demographics, vascular risk factors, stroke characteristics, and functional outcomes. Patients were stratified by INR into "therapeutic" and "subtherapeutic" groups. Stroke severity (NIH Stroke Scale), infarct volume, and outcome (modified Rankin Scale) were assessed on admission, discharge, and follow-up (3 months poststroke). Differences were calculated using Student's t-tests and regression analyses. Results: The average INR on admission was 1.6 for the entire cohort. Seventy six percent were subtherapeutic on admission (INR < 2.0). Therapeutic patients had lower National Institutes of Health Stroke Scale scores on admission (5.9 versus 9.5, P = .033), significantly smaller stroke volumes (19.5 cc versus 49.2 cc, P = .036), and were more likely to show more than 1 digit improvement on follow-up mRS than subtherapeutic patients. Conclusions: Stroke size and severity is significantly reduced in patients with ischemic strokes who present therapeutic on warfarin. The greater volume of brain saved may ultimately lead to better functional recovery.
机译：背景：事先研究表明，Warfarin对于具有心房颤动的个体中的初级和次级中风预防是有效的。还众所周知，具有心房颤动的华法林的那些往往具有较差的长期失败结果，可能是因为心脏栓塞中风往往更大，更严重。关于在严重程度或长期功能状态下行程时的国际归一化比率（INR）值的直接效应的直接影响。方法：我们预示着连续的112名患者，在2013年和2018年在华法林之间与急性缺血性卒中呈急性缺血性卒中。随着INR入学，对患者人口统计学，血管危险因素，中风特征和功能结果进行数据。患者通过INR分层成“治疗性”和“亚治疗性”基团。在入院，排放和随访时评估卒中严重程度（NIH中风量表），梗塞体积和结果（改进的Rankin Scale）（3个月的失败者）。使用学生的T检验和回归分析计算差异。结果：整个队列的入场上的平均INR为1.6。七十六个百分之六六治疗（INR <2.0）。治疗性患者在入场时较低的国家卫生冲程量表评分（5.9与9.5，P = .033），中风卷显着更小（19.5 CC与49.2 CC，P = .036），更有可能显示超过1比次治疗患者的后续夫人的数字改善。结论：缺血性卒中患者患者患有Warfarin治疗的脑卒中大小和严重程度显着降低。节省的大量大脑可能最终导致更好的功能恢复。

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