Neurology:饮酒患者可进行静脉溶栓治疗

2015-10-19 phylis 译 MedSci原创

目的:为了确定是否慢性饮酒或急性酒精中毒影响急性缺血性卒中患者(IS)静脉溶栓(IVT)率和症状性脑出血(SICH)相关风险。方法:研究者分析奥地利卒中单元登记记录的2004年到2014年间35个卒中单元的所有IS患者。研究者比较慢性饮酒(大于2次/天)或急性酒精中毒的患者和无饮酒的患者的人口学资料和临床特征,以及IVT发生率及相关SICH。结果:研究者识别了IS患者47422名。这些患者中,39

目的:为了确定慢性饮酒或急性酒精中毒是否影响急性缺血性卒中患者(IS)静脉溶栓(IVT)率和症状性脑出血(SICH)相关风险。

方法:研究者分析奥地利卒中单元登记记录的2004年到2014年间35个卒中单元的所有IS患者。研究者比较慢性饮酒(大于2次/天)或急性酒精中毒的患者和无饮酒的患者的人口学资料和临床特征,以及IVT发生率及相关SICH。

结果:研究者识别了IS患者47422名。这些患者中,3999名(8.5%)慢性饮酒,216名(0.5%)曾出现急性酒精中毒。酒精滥用者较年轻,大多为男性,在缺血时间发生前较少存在功能障碍。饮酒和不饮酒的IS患者,卒中严重程度没有差异。然而,饮酒患者进行IVT治疗者较少(16.6 vs18.9%),这个差异在校正了混杂因素后仍存在。酒精滥用患者IVT后SICH发生率没有升高(2.1%VS3.7%)。多变量分析包括年龄、NIHSS分数、症状开始到IVT治疗时间显示滥用酒精不是SICH发生的独立危险因素,也没有保护作用(OR O.73,95%CI 0.43-1.25)。

结论:慢性饮酒或急性酒精中毒的IS患者接受IVT的可能性减少,也不能增加SICH的风险。这就支持当前临床威廉亚洲博彩公司 ,未将慢性饮酒或急性酒精中毒作为排除标准。

原文出处:

Gattringer T, Enzinger C, Fischer R, et al. IV thrombolysis in patients with ischemic stroke and alcohol abuse. Neurology. 2015, Oct 7.


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    2016-06-19 fusion
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    2015-12-11 yinhl1978
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    2015-10-21 lqvr
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    2015-10-20 lixh1719

    当然可以

    0

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     溶栓后是否出现神经功能改善,梗阻动脉再通都与良好预后相关 缺血性卒中患者静脉溶栓后的再通状态是进行补救再灌注干预的一个参考点,尽管早期神经功能改善可能排除血管内操作。为了评估重建梗阻部位血流的重要性,瑞典斯德哥尔摩Karolinska研究所Karolinska大学医院神经内卒中研究中心的Tatiana V. Kharitonova博士等人进行了一项研究,研究结果在

Stroke:男性卒中患者静脉溶栓预后或较女性差

静脉组织型纤溶酶原激活剂(tPA)为治疗急性缺血性卒中的主要措施,但对于静脉溶栓的预后结果是否存在性别差异的研究结论并不一致,一些临床随机试验表明,女性从静脉rtPA受益更多,但一些研究却提示男性受益为女性的3倍。 针对这种情况,来自意大利罗马智慧大学的Lorenzano S等人进行了一项研究,williamhill asia 的研究目的是评估使用静脉组织类型纤溶酶原激活物治疗急性缺血性脑卒中患者