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Neurology：替奈普酶改善缺血性卒中患者血管再通！

2017-06-03 xing.T MedSci原创

替奈普酶阿替普酶卒中再通
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由此可见，采用替奈普酶治疗可以获得更大的再通疗效，相比于阿替普酶。

近日，神经病学领域权威取杂志Neurology上发表了一篇研究文章，研究人员旨在明确完全血管闭塞的患者采用替奈普酶治疗是否比阿替普酶获得24小时更大的血管再通以及改善24小时和90天临床结局。

研究人员收集个2个比较替奈普酶和阿替普酶的临床2期随机试验临床和影像学资料，研究人员采用CT血管造影（CTA）扫描允来评估基础血管闭塞状态，以及使用改良的脑梗塞溶栓治疗（TICI）量表许来评估溶栓后24小时血管闭塞状态。研究人员采用线性回归比较了治疗组间卒中后24小时国立卫生研究院卒中量表（NIHSS）和90天改良的Rankin 量表（mRS）评分，并得到了比值比（OR）。

该研究共合并了146例患者，69例患者基础整体闭塞程度有TICI为0/1。接受替奈普酶治疗的完全血管闭塞患者在24小时有更完整的血管再通率（替奈普酶为71% vs. 阿替普酶为43%，P＜0.001）。闭塞程度为TICI0/1的患者采用替奈普酶治疗也获得了更大的早期临床改善（替奈普酶治疗的平均NIHSS变化为9，四分位数间距[IQR]为6，阿替普酶为1，IQR为1，P=0.001），并获得90天的良好结局的几率也较高（替奈普酶与阿替普酶比较mRS0-1，比值比为4.82，95%可信区间为1.02-7.84，P=0.05）。

由此可见，采用替奈普酶治疗可以获得更大的再通疗效，相比于阿替普酶。

原始出处：

Andrew Bivard,  et al. Tenecteplase in ischemic stroke offers improved recanalization Analysis of 2 trials. Neurology. 2017. http://dx.doi.org/10.1212/WNL.0000000000004062

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    2018-04-15 wjywjy

    #缺血性卒中患者#

    0

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    2017-09-15 wangyang7969

    #卒中患者#

    0

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    2017-09-06 yinhl1978

    #Neurol#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2010368, encodeId=cf512010368ee, content=<a href='/topic/show?id=9cf7e9360d2' target=_blank style='color:#2F92EE;'>#缺血性卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79360, encryptionId=9cf7e9360d2, topicName=缺血性卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Sun Apr 15 15:37:00 CST 2018, time=2018-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720181, encodeId=922d1e20181fb, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Fri Sep 15 06:37:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999962, encodeId=c5101999962c1, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Sep 06 01:37:00 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806155, encodeId=9402180615528, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Apr 21 06:37:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892878, encodeId=20fe18928e838, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu May 17 02:37:00 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206655, encodeId=2bd3206655e0, content=希望便宜点, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Mon Jun 05 06:42:16 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445705, encodeId=3fd61445e05e3, content=<a href='/topic/show?id=c77e6034264' target=_blank style='color:#2F92EE;'>#替奈普酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60342, encryptionId=c77e6034264, topicName=替奈普酶)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=81bf5152010, createdName=12499e01m48暂无昵称, createdTime=Mon Jun 05 01:37:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206491, encodeId=f3a620649170, content=未来的发展前景广阔, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 04 19:11:10 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205974, encodeId=9b1f2059e430, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat Jun 03 10:42:27 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2018-04-21 12498da4m32(暂无昵称)

    #缺血性卒#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2010368, encodeId=cf512010368ee, content=<a href='/topic/show?id=9cf7e9360d2' target=_blank style='color:#2F92EE;'>#缺血性卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79360, encryptionId=9cf7e9360d2, topicName=缺血性卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Sun Apr 15 15:37:00 CST 2018, time=2018-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720181, encodeId=922d1e20181fb, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Fri Sep 15 06:37:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999962, encodeId=c5101999962c1, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Sep 06 01:37:00 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806155, encodeId=9402180615528, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Apr 21 06:37:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892878, encodeId=20fe18928e838, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu May 17 02:37:00 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206655, encodeId=2bd3206655e0, content=希望便宜点, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Mon Jun 05 06:42:16 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445705, encodeId=3fd61445e05e3, content=<a href='/topic/show?id=c77e6034264' target=_blank style='color:#2F92EE;'>#替奈普酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60342, encryptionId=c77e6034264, topicName=替奈普酶)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=81bf5152010, createdName=12499e01m48暂无昵称, createdTime=Mon Jun 05 01:37:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206491, encodeId=f3a620649170, content=未来的发展前景广阔, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 04 19:11:10 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205974, encodeId=9b1f2059e430, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat Jun 03 10:42:27 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2018-05-17 guihongzh

    #缺血性#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2010368, encodeId=cf512010368ee, content=<a href='/topic/show?id=9cf7e9360d2' target=_blank style='color:#2F92EE;'>#缺血性卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79360, encryptionId=9cf7e9360d2, topicName=缺血性卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1072181, createdName=wjywjy, createdTime=Sun Apr 15 15:37:00 CST 2018, time=2018-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720181, encodeId=922d1e20181fb, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Fri Sep 15 06:37:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999962, encodeId=c5101999962c1, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Sep 06 01:37:00 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806155, encodeId=9402180615528, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Apr 21 06:37:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892878, encodeId=20fe18928e838, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu May 17 02:37:00 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206655, encodeId=2bd3206655e0, content=希望便宜点, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Mon Jun 05 06:42:16 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1445705, encodeId=3fd61445e05e3, content=<a href='/topic/show?id=c77e6034264' target=_blank style='color:#2F92EE;'>#替奈普酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60342, encryptionId=c77e6034264, topicName=替奈普酶)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=81bf5152010, createdName=12499e01m48暂无昵称, createdTime=Mon Jun 05 01:37:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206491, encodeId=f3a620649170, content=未来的发展前景广阔, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jun 04 19:11:10 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205974, encodeId=9b1f2059e430, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sat Jun 03 10:42:27 CST 2017, time=2017-06-03, status=1, ipAttribution=)]
    2017-06-05 meiliwuxian

    希望便宜点

    0

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    2017-06-05 12499e01m48暂无昵称

    #替奈普酶#

    0

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    2017-06-04 虈亣靌

    未来的发展前景广阔

    0

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    2017-06-03 tanxingdoctor

    学习啦谢谢分享

    0