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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Outcomes of thrombolytic therapy for acute ischemic stroke in Chinese patients: the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) study.
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Outcomes of thrombolytic therapy for acute ischemic stroke in Chinese patients: the Taiwan Thrombolytic Therapy for Acute Ischemic Stroke (TTT-AIS) study.

机译：中国患者急性缺血性卒中溶栓治疗的结果：台湾急性缺血性卒中溶栓治疗（TTT-AIS）研究。

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BACKGROUND AND PURPOSE: The safety and efficacy of alteplase for ischemic stroke has not been examined in Chinese patients. We assessed the safety and efficacy of alteplase for acute ischemic stroke in daily clinical practice in Taiwan. METHODS: A prospective, multicenter, observational study was conducted in Taiwan from December 2004 to July 2008. Eligible patients (241) receiving alteplase were recruited and divided into 2 groups: standard dose (0.90 + or - 0.02 mg/kg, n=125) and lower dose (0.72 + or - 0.07 mg/kg, n=116). Primary outcome measures were safety: symptomatic intracerebral hemorrhage and death within 3 months. The secondary outcome measure was efficacy a modified Rankin scale of 0 to 2 after 3 months. RESULTS: The standard-dose group had higher rates of symptomatic intracerebral hemorrhage using National Institute of Neurological Diseases and Stroke, European Cooperative Acute Stroke Study, and Safe Implementation of Thrombolysis in Stroke-Monitoring Study definitions (10.4% versus 5.2%, 8.0% versus 2.6%, and 5.6% versus 1.7%, respectively) and mortality within 3 months (12.8% versus 6.9%), twice that of the lower-dose group. This pattern was more prominent in older patients. Significantly higher rates of symptomatic intracerebral hemorrhage per European Cooperative Acute Stroke Study (15.4% versus 3.3%, P=0.0257) and mortality (21.1% versus 5.0%, P=0.0099) and significantly lower independence rate (32.6% versus 53.6%, P=0.0311) were observed among patients > or = 70 years old receiving the standard dose than those receiving the lower dose. CONCLUSIONS: This study suggests that the standard dose of 0.9 mg/kg alteplase may not be optimal for treating aged Chinese patients. However, the dose of recombinant tissue plasminogen activator for ischemic stroke in Chinese patients should be based on more broad and convincing evidences and randomized trials of lower versus higher doses are needed.
机译：背景与目的：尚未在中国患者中检测到阿替普酶治疗缺血性中风的安全性和有效性。我们在台湾的日常临床实践中评估了阿替普酶治疗急性缺血性中风的安全性和有效性。方法：从2004年12月至2008年7月在台湾进行了一项前瞻性，多中心，观察性研究。招募了符合条件的241名接受阿替普酶治疗的患者，分为2组：标准剂量（0.90 +或-0.02 mg / kg，n = 125） ）和较低剂量（0.72 +或-0.07 mg / kg，n = 116）。主要的预后指标是安全性：症状性脑出血和3个月内死亡。次要结局指标是3个月后用改良的Rankin评分从0到2的疗效。结果：使用美国国家神经疾病与中风研究所，欧洲合作急性中风研究和中风监测研究定义中的溶栓安全实施，标准剂量组的症状性脑出血发生率更高（10.4％对5.2％，8.0％对在三个月内的死亡率分别为2.6％，5.6％和1.7％，分别为12.8％和6.9％，是低剂量组的两倍。这种模式在老年患者中更为突出。根据欧洲合作性急性卒中研究，症状性脑出血的发生率显着更高（15.4％比3.3％，P = 0.0257）和死亡率（21.1％比5.0％，P = 0.0099）和显着降低的独立率（32.6％比53.6％，P）在接受标准剂量的年龄大于或等于70岁的患者中观察到= 0.0311）。结论：这项研究表明0.9mg / kg阿替普酶的标准剂量可能不是治疗老年中国患者的最佳选择。然而，针对中国缺血性卒中的重组组织纤溶酶原激活剂的剂量应基于更广泛和令人信服的证据，并且需要低剂量与高剂量的随机试验。

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