Stroke:基线弥散加权成像病变体积较大卒中的再灌注治疗结局

2018-02-03 国际循环编辑部 国际循环

再灌注治疗时,人们常常会除外弥散加权成像(DWI)体积较大的卒中患者。Stroke发表一项有关THRACE研究(卒中后单用阿替普酶及阿替普酶联合机械取栓的对比研究)的亚组分析评估DWI体积> 70 ml的卒中患者基线参数与结局的相关性。

再灌注治疗时,人们常常会除外弥散加权成像(DWI)体积较大的卒中患者。Stroke发表一项有关THRACE研究(卒中后单用阿替普酶及阿替普酶联合机械取栓的对比研究)的亚组分析评估DWI体积>70 ml的卒中患者基线参数与结局的相关性。

研究对THRACE研究中304例治疗前接受磁共振成像的前循环缺血性卒中患者进行分析,从THRACE数据库中提取相关变量,并采用半自动化方法测量DWI体积。结果发现,受试患者中DWI体积>70 ml者共计53例,随访3个月时12例结局良好(改良Rankin量表评分≤2分)。与结局较差的改良Rankin量表评分>2分的38例患者相比,上述结局较好的12例患者较少存在冠状动脉疾病(0例vs.12例,P=0.046),更少有吸烟史(1例vs.12例,P=0.013)。此外,共计有8例患者年龄超过75岁,这些患者的改良Rankin量表评分均>2。受试患者中MI闭塞及颈内动脉-T/L闭塞者分别为37例和16例;与后者相比,前者更容易实现良好结局(12例vs.0例,P=0.010)。另外,受试患者中DWI病变仅限于大脑中动脉浅表区域者及延伸至大脑中动脉深层区域者分别为13例和40例;与后者相比,前者更多可实现良好结局(6/13 vs.6/40,P=0.050)。

上述结果提示,DWI病变体积超过70 ml的卒中患者也可从再灌注治疗中获益,尤其是单纯MI闭塞或是缺血仅限于大脑中动脉浅表区域的患者。但当上述患者存在颈动脉闭塞或病变延伸至大脑中动脉深部时再灌注治疗似乎并未带来获益。

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    2018-02-08 三生有幸9135

    学习一下谢谢分享

    0

  4. 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topicList=[TopicDto(id=30649, encryptionId=7b2130649c9, topicName=再灌注治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e33a8492666, createdName=xjy05, createdTime=Mon Feb 05 14:52:00 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=285195, encodeId=34cb2851954b, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Mon Feb 05 00:52:56 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284974, encodeId=9d6e2849e420, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Feb 04 08:37:55 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284964, encodeId=b0bf28496455, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Feb 04 08:27:12 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284957, encodeId=703128495ef2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sun Feb 04 08:22:53 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284949, encodeId=b9ab28494963, content=再灌注治疗与栓塞血管及面积有关, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Feb 04 07:46:33 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284946, encodeId=bcda28494667, content=谢谢分享学习, beContent=null, 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  5. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sun Feb 04 08:22:53 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284949, encodeId=b9ab28494963, content=再灌注治疗与栓塞血管及面积有关, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Feb 04 07:46:33 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284946, encodeId=bcda28494667, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Feb 04 07:43:36 CST 2018, time=2018-02-04, status=1, ipAttribution=)]
    2018-02-05 三生有幸9135

    学习一下谢谢分享

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Feb 04 07:43:36 CST 2018, time=2018-02-04, status=1, ipAttribution=)]
    2018-02-04 深海的鱼

    学习学习学习

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Feb 04 08:37:55 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284964, encodeId=b0bf28496455, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Feb 04 08:27:12 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284957, encodeId=703128495ef2, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Sun Feb 04 08:22:53 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284949, encodeId=b9ab28494963, content=再灌注治疗与栓塞血管及面积有关, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Feb 04 07:46:33 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284946, encodeId=bcda28494667, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Feb 04 07:43:36 CST 2018, time=2018-02-04, status=1, ipAttribution=)]
    2018-02-04 1dd8c52fm63(暂无匿称)

    了解了解.继续关注

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Feb 04 07:43:36 CST 2018, time=2018-02-04, status=1, ipAttribution=)]
    2018-02-04 明月清辉

    谢谢分享.学习了

    0

  9. 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objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Feb 04 07:43:36 CST 2018, time=2018-02-04, status=1, ipAttribution=)]
    2018-02-04 邓启付

    再灌注治疗与栓塞血管及面积有关

    0

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    2018-02-04 清风拂面

    谢谢分享学习

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