Iodinated contrast prior to thrombolysis was not associated with worse intracranial hemorrhage.
Iodinated contrast prior to thrombolysis was not associated with worse intracranial hemorrhage.
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溶栓前使用碘造影剂与更严重的颅内出血无关。
DOI：
10.1111/acem.12603
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Banuelos,RosaC
中科院分区：
文献类型：
--
作者：
Radecki,RyanP;Azam,Arif;Doshi,PratikB;Banuelos,RosaC
目的 目的是评估溶栓前接受和未接受碘造影剂的患者之间临床不良反应的相对发生率。方法这是对 2004 年至 2012 年间因急性缺血性卒中而接受重组组织型纤溶酶原激活剂 (rt-PA) 治疗的急诊科患者进行的回顾性登记审查。作者比较了所有级别的颅内出血 (ICH)、症状性颅内出血的发生率(sICH)，以及溶栓前接受计算机断层扫描血管造影 (CTA) 的患者与未接受溶栓治疗的患者之间的院内死亡。 结果 共有 1,014 名符合纳入标准的患者可供分析。共有 473 名患者在 rt-PA 给药前接受了 CTA。各组的基线特征总体相似，但 CTA 组的急性梗塞和陈旧性卒中迹象较少（分别为 28.8% vs. 8.5% 和 9.9% vs. 3.7%）和肌酐。不良事件结果在各组之间的分布并不一致。 CTA 组患者的 ICH 发生率相似（11.0% vs. 8.1%，p=0.120），但 II 型脑实质出血较少（2.1% vs. 4.6%，p=0.025），院内死亡较少（7.2% vs. 12.6%，p=0.005）。结论 没有观察到与静脉注射碘相关的一致危害。 rt-PA 给药前的对比。根据临床指示，在溶栓前继续进行 CTA 是合理的。
ObjectivesThe objective was to assess relative incidence of clinical adverse effects between patients receiving, and not receiving, iodinated contrast prior to thrombolysis.MethodsThis was a retrospective registry review of patients presenting to the emergency department treated with recombinant tissue‐type plasminogen activator (rt‐PA) for acute ischemic stroke between 2004 and 2012. The authors compared the occurrence of all grades of intracranial hemorrhage (ICH), symptomatic intracranial hemorrhage (sICH), and in‐hospital deaths between patients undergoing computed tomographic angiography (CTA) prior to thrombolysis and those who did not.ResultsA total of 1,014 patients were available for analysis meeting inclusion criteria. A total of 473 patients underwent CTA prior to rt‐PA administration. Baseline characteristics were generally similar across groups, excepting fewer signs of acute infarct and old stroke in the CTA group (28.8% vs. 8.5% and 9.9% vs. 3.7%, respectively) and creatinine. Adverse event outcomes were not consistently distributed across the groups. Patients in the CTA group had a similar incidence of any ICH (11.0% vs. 8.1%, p=0.120), but fewer type II parenchymal hemorrhages (2.1% vs. 4.6%, p=0.025) and fewer in‐hospital deaths (7.2% vs. 12.6%, p=0.005).ConclusionsNo consistent harms were observed in association with intravenous iodinated contrast prior to rt‐PA administration. It is reasonable to continue CTA prior to thrombolysis as clinically indicated.
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