重组组织型纤溶酶原激活剂(r-TPA)治疗急性缺血性脑卒中患者脑氧饱和度与临床疗效的关系

Advanced Journal of Emergency Medicine Pub Date : 2019-08-17 eCollection Date: 2020-01-01 DOI:10.22114/ajem.v0i0.174
Sepideh Paybast, Ali Ashraf, Hakimeh Sarshad, Maryam Shakiba, Yasser Moadabi
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引用次数: 5

摘要

目前,最有效的治疗急性缺血性卒中(AIS)是重组组织型纤溶酶原激活剂(r-TPA)溶栓治疗。r-TPA治疗的一个挑战是预测每个病例的恢复情况。目的:探讨脑血氧仪指标与r-TPA治疗临床效果的关系,评价脑血氧仪作为无创治疗监测手段的价值。方法:纳入标准均为接受r-TPA治疗的AIS患者。在到达时和24小时后,根据美国国立卫生研究院卒中量表(NIHSS)评分对神经系统状况进行评估。此外,在注射r-TPA前和注射后24小时内,使用额叶血氧传感器连续测量了两个半球的脑氧合水平。临床成功被定义为比基线NIHSS提高4分。结果:共纳入44例患者,平均年龄(58.2±2.18)岁,其中男性占68.18%。28例患者临床无改善,16例患者改善。改善组与未改善组相比,24小时内患半球脑血氧曲线下的平均表面积有显著差异(P = 0.007)。改善组和未改善组24小时内脑氧合平均增加量差异有统计学意义(P = 0.002)。结论:脑血氧测定可能有助于预测AIS患者r-TPA预后的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Propagating Relationship of Cerebral Oximetric Volume and the Clinical Outcome of Recombinant Tissue Plasminogen Activator (r-TPA) Therapy on Acute Cerebral Ischemic Stroke Patients.

Propagating Relationship of Cerebral Oximetric Volume and the Clinical Outcome of Recombinant Tissue Plasminogen Activator (r-TPA) Therapy on Acute Cerebral Ischemic Stroke Patients.

Propagating Relationship of Cerebral Oximetric Volume and the Clinical Outcome of Recombinant Tissue Plasminogen Activator (r-TPA) Therapy on Acute Cerebral Ischemic Stroke Patients.

Introduction: Currently, the most available treatment for acute ischemic stroke (AIS) is thrombolytic therapy with recombinant tissue plasminogen activator (r-TPA). A challenge in r-TPA therapy is the prediction of recovery in each case.

Objective: The aim was to find a possible relationship between the cerebral oximetry indexes and the clinical outcome of r-TPA therapy to assess the cerebral oximetry as a non-invasive monitoring agent for therapy.

Methods: The inclusion criteria were all patients with AIS who received r-TPA. The neurologic status was evaluated based on the national institutes of health stroke scale (NIHSS) score at arrival, and after a period of 24 hours. In addition, the levels of brain oxygenation in both hemispheres were measured before and continuously over the first 24 hours after r-TPA injection, using an oximetric sensor in the frontal lobes. The clinical success was defined as a 4-point improvement from the baseline NIHSS.

Results: Total 44 patients with the mean age of 58.2 ± 2.18 years were enrolled, of whom 68.18% were male. Twenty-eight patients remained clinically unimproved and 16 patients were improved. A significant difference was found in the mean surface area under the brain oximetric curve in the 24 hour, in the affected hemisphere in the improved group, compared to the unimproved group (P = 0.007). There was a significant difference between the mean increase in brain oxygenation within 24 hours in the improved and unimproved groups (P = 0.002).

Conclusion: It is likely that, The cerebral oximetry could contribute to predict the likelihood of r-TPA prognosis in patients with AIS.

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