Reduced Platelet Activity Is Associated With Early Clot Growth and Worse 3-Month Outcome After Intracerebral Hemorrhage
Reduced Platelet Activity Is Associated With Early Clot Growth and Worse 3-Month Outcome After Intracerebral Hemorrhage
复制标题
血小板活性降低与脑出血后早期血栓生长和更糟糕的 3 个月结果相关
作者：
A. Naidech;B. Jovanovic;S. Liebling;Rajeev K. Garg;S. Bassin;B. Bendok;Richard A. Bernstein;Mark J. Alberts;H. Batjer
背景和目的——抗血小板药物的使用和血小板活性降低可能与脑出血（ICH）后的死亡率相关。我们检验了血小板活性降低与早期脑出血凝块生长和更差结果相关的假设。方法——我们前瞻性地识别自发性脑出血患者，入院时测量血小板活性（VerifyNow-ASA，Accumetrics），并记录抗血小板药物的使用情况。使用计算机体积分析计算ICH体积。数据采用非参数统计进行分析，并酌情重复测量方差分析。对患者的功能结果进行前瞻性随访。数据以平均值±SD 或中位数表示[Q1 至Q3]。结果 — 对于 12 小时内进行诊断性 CT 的患者，血小板活性降低（≤550 阿司匹林反应单位 [ARU]）与 ICH 体积增长增加相关（P<0.05）。在未知服用阿司匹林的患者亚组中，24% 的患者血小板活性降低。 16 名 (24%) 患者在症状出现后 21.2±11.4 小时接受血小板输注，血小板活性增加（448 [414-479] 至 586 [530-639] ARU，P=0.001），但对结果没有影响。血小板活性降低与 3 个月时改良Rankin 评分较差相关（P=0.02）。结论——血小板活性降低与早期 ICH 体积增长和较差的功能结果相关。由于血小板输注可以增加血小板活性，因此增加血小板活性是减少 ICH 体积增长和改善功能结果的潜在方法。
Background and Purpose— Antiplatelet medication use and reduced platelet activity may be associated with mortality after intracerebral hemorrhage (ICH). We tested the hypothesis that reduced platelet activity is associated with early ICH clot growth and worse outcomes. Methods— We prospectively identified patients with spontaneous ICH, measured platelet activity (VerifyNow-ASA, Accumetrics) on admission, and recorded antiplatelet medication use. ICH volume was calculated using computerized volumetric analysis. Data were analyzed with nonparametric statistics and repeated measures ANOVA as appropriate. Patients were prospectively followed for functional outcomes. Data are presented as mean±SD or median [Q1 to Q3]. Results— Reduced platelet activity (≤550 aspirin reaction units [ARU]) was associated with increased ICH volume growth (P<0.05) for patients with the diagnostic CT within 12 hours. In the subset of patients not known to take aspirin, 24% had reduced platelet activity. Sixteen (24%) patients received a platelet transfusion 21.2±11.4 hours after symptom onset with an increase in platelet activity (448 [414-479] to 586 [530-639] ARU, P=0.001), but without impact on outcomes. Reduced platelet activity was associated with worse modified Rankin Scores at 3 months (P=0.02). Conclusions— Reduced platelet activity was associated with early ICH volume growth and worse functional outcome. Because platelet activity can be increased with platelet transfusion, increasing platelet activity is a potential method to reduce ICH volume growth and improve functional outcomes.
DOI：
10.1007/978-3-211-09469-3_41
发表时间：
2008
期刊：
Acta neurochirurgica. Supplement
影响因子：
--
作者：
Timothy C. Morgan;I. Awad;P. Keyl;K. Lane;D. Hanley
通讯作者：
Timothy C. Morgan;I. Awad;P. Keyl;K. Lane;D. Hanley
影响因子：
8.3
作者：
Brott, T;Broderick, J;Khoury, J
通讯作者：
Khoury, J