急性脑梗死静脉溶栓前MRI检查的可行性与安全性研究

被引：7

作者：

周颖奇

单培佳

单连标

王施

周建光

机构：

[1] 解放军第医院神经内科

来源：

第三军医大学学报 | 2013年 / 35卷 / 06期

关键词：

急性脑梗死; 静脉溶栓; MRI;

D O I：

10.16016/j.1000-5404.2013.06.023

中图分类号：

R743.33 [脑栓塞];

学科分类号：

1002 ;

摘要：

目的了解急性脑梗死患者静脉溶栓前实施MRI检查的可行性及安全性。方法采用包含MRI检查的优化溶栓流程,对我院2010年4月至2012年5月的急性脑梗死患者进行了静脉溶栓。观察并记录患者的发病-溶栓时间(onset to treatment time,OTT)、急诊-溶栓时间(door to needle time,DNT)以及溶栓后的临床转归;并将其与国内外公开发表、采用CT检查流程的静脉溶栓研究的同类数据进行比较。结果本组108例静脉溶栓患者中溶栓前行MRI检查的100例(92.6%)。溶栓前所耗时间:发病-溶栓的中位时间为180 min、急诊-溶栓中位时间为85 min。溶栓后90 d时良好结局的(改良Rankin评分0～1分)比例为50.9%(55/108)、症状性颅内出血率为3.7%(4/108)。与采用CT检查的同类对照研究数据相比,溶栓前所耗时间小于中国国家卒中注册研究的结果;溶栓后90 d时的良好结局及症状性颅内出血率均显著优于赫尔辛基注册研究的数据(P<0.05,P<0.01)。结论优化流程下的MRI检查未延误患者的溶栓时间,也未恶化溶栓患者的临床转归,故静脉溶栓前行MRI检查安全、可行。

引用

页码：558 / 561

页数：4

共 12 条

[1] 中国急性缺血性脑卒中诊治指南2010 [J].

中华神经科杂志, 2010, (02)

[2]

Reperfusion Therapy in Unclear-Onset Stroke Based on MRI Evaluation (RESTORE): A Prospective Multicenter Study[J] . Dong-Wha Kang,Sung-Il Sohn,Keun-Sik Hong,Kyung-Ho Yu,Yang-Ha Hwang,Moon-Ku Han,Jun Lee,Jong-Moo Park,A-Hyun Cho,Hye-Jin Kim,Dong-Eog Kim,Yong-Jin Cho,Jaseong Koo,Sung-Cheol Yun,Sun U. Kwon,Hee-Joon Bae,Jong S. Kim.Stroke . 2012 (12)

[3]

Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis[J] . Joanna M Wardlaw,Veronica Murray,Eivind Berge,Gregory del Zoppo,Peter Sandercock,Richard L Lindley,Geoff Cohen.The Lancet . 2012 (9834)

[4]

Recombinant Tissue-Type Plasminogen Activator Use for Ischemic Stroke in the United States: A Doubling of Treatment Rates Over the Course of 5 Years[J] . Opeolu Adeoye,Richard Hornung,Pooja Khatri,Dawn Kleindorfer.Stroke . 2011 (7)

[5]

Using Recombinant Tissue Plasminogen Activator to Treat Acute Ischemic Stroke in China: Analysis of the Results From the Chinese National Stroke Registry (CNSR)[J] . Yilong Wang,Xiaoling Liao,Xingquan Zhao,David Z. Wang,Chunxue Wang,Mai N. Nguyen-Huynh,Yong Zhou,Liping Liu,Xianwei Wang,Gaifen Liu,Hao Li,Yongjun Wang.Stroke . 2011 (6)

[6] Current Status of Endovascular Stroke Treatment [J].

Meyers, Philip M. ;

Schumacher, H. Christian ;

Connolly, E. Sander, Jr. ;

Heyer, Eric J. ;

Gray, William A. ;

Higashida, Randall T. .

CIRCULATION, 2011, 123 (22) :2591-2601

[7] Off-Label Thrombolysis Is Not Associated With Poor Outcome in Patients With Stroke [J].

Meretoja, Atte ;

Putaala, Jukka ;

Tatlisumak, Turgut ;

Atula, Sari ;

Artto, Ville ;

Curtze, Sami ;

Happola, Olli ;

Lindsberg, Perttu J. ;

Mustanoja, Satu ;

Piironen, Katja ;

Pitkaniemi, Janne ;

Rantanen, Kirsi ;

Sairanen, Tiina ;

Salonen, Oili ;

Silvennoinen, Heli ;

Soinne, Lauri ;

Strbian, Daniel ;

Tiainen, Marjaana ;

Kaste, Markku .

STROKE, 2010, 41 (07) :1450-1458

[8]

Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials[J] . Kennedy R Lees,Erich Bluhmki,Rüdiger von Kummer,Thomas G Brott,Danilo Toni,James C Grotta,Gregory W Albers,Markku Kaste,John R Marler,Scott A Hamilton,Barbara C Tilley,Stephen M Davis,Geoffrey A Donnan,Werner Hacke.The Lancet . 2010 (9727)

[9] Focal Fluid-Attenuated Inversion Recovery Hyperintensity Within Acute Diffusion-Weighted Imaging Lesions Is Associated With Symptomatic Intracerebral Hemorrhage After Thrombolysis [J].

Cho, A-Hyun ;

Kim, Jong S. ;

Kim, Sang-Joon ;

Yun, Sung-Cheol ;

Choi, Choong-Gon ;

Kim, Hyoung-Ryoul ;

Kwon, Sun U. ;

Lee, Deok-Hee ;

Kim, Eun-Kyung ;

Suh, Dae-Chul ;

Kang, Dong-Wha .

STROKE, 2008, 39 (12) :3424-3426

[10]

Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study[J] . Nils Wahlgren,Niaz Ahmed,Antoni Dávalos,Gary A Ford,Martin Grond,Werner Hacke,Michael G Hennerici,Markku Kaste,Sonja Kuelkens,Vincent Larrue,Kennedy R Lees,Risto O Roine,Lauri Soinne,Danilo Toni,Geert Vanhooren.The Lancet . 2007 (9558)

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