The efficacy of intravenous thrombolysis in acute ischemic stroke patients with white matter hyperintensity.
The efficacy of intravenous thrombolysis in acute ischemic stroke patients with white matter hyperintensity.
复制标题
静脉溶栓治疗急性缺血性脑卒中脑白质高信号患者的疗效
DOI：
10.1002/brb3.1149
复制
发表时间：
2018-12
影响因子：
3.1
通讯作者：
Zhou X
中科院分区：
文献类型：
--
作者：
Liu Y;Zhang M;Bao H;Zhang Z;Mei Y;Yun W;Zhou X
我们的目的是探讨深白色高信号（DWMH）和脑室周围高信号（PVH）对急性缺血性卒中（AIS）患者静脉溶栓（IVT）疗效的影响。共113例AIS合并WMH患者根据病变部位分为PVH组和DWMH组，根据是否接受IVT治疗分为两个亚组：溶栓组和对照组。采用Kaplan-Meier分析复发性卒中的比例风险。进一步采用多因素考克斯回归分析。在所有患者中，有62例PVH患者和51例DWMH患者：27例PVH患者和22例DWMH患者接受了IVT，其余患者仅接受常规治疗。在溶栓组中，DWMH患者的END（36.4% vs. 11.1%; p = 0.034）和HT（22.7% vs. 3.7%; p = 0.038）风险高于PVH患者。此外，接受IVT的DWMH患者的END（36.4% vs. 10.3%; x 2 = 5.050; p = 0.025）和HT（22.7% vs. 3.4%; x 2 = 4.664; p = 0.031）风险也高于未接受IVT的DWMH患者。同样，90天随访后，PVH患者的卒中复发率（20.0% vs. 3.4%; p = 0.034）高于对照组DWMH患者。Kaplan-Meier分析显示无主要终点事件的累积概率存在显著差异（p = 0.039）。此外，多变量考克斯回归显示，在调整混杂因素后，PVH是AIS患者卒中复发的独立危险因素。WMH的位置与AIS患者IVT的疗效密切相关。
We aimed to investigate effects of deep white matter hyperintensity (DWMH) and periventricular hyperintensity (PVH) on the efficacy of intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). A total of 113 AIS patients with WMH were categorized into the PVH group and the DWMH group according to the lesion location, with the division of two subgroups based on whether or not they received IVT treatment: the thrombolysis group and the control group. Kaplan–Meier analysis was used for proportional hazards of recurrent stroke. Further, multivariate Cox regression analysis was employed. Of total patients, there were 62 PVH patients and 51 DWMH patients: 27 of PVH patients and 22 of DWMH patients received IVT, and the remaining patients only received routine treatment. DWMH patients had a higher risk of END (36.4% vs. 11.1%; p = 0.034) and HT (22.7% vs. 3.7%; p = 0.038) than PVH patients in the thrombolysis group. Moreover, DWMH patients undergoing IVT also had a higher risk of END (36.4% vs. 10.3%; x 2 = 5.050; p = 0.025) and HT (22.7% vs. 3.4%; x 2 = 4.664; p = 0.031) than DWMH patients without IVT. Again, PVH patients had a higher rate of recurrent stroke (20.0% vs. 3.4%; p = 0.034) than DWMH patients in the control group after 90‐day follow‐up. Kaplan–Meier analysis showed a significant difference in cumulative probability of no major endpoint events (p = 0.039). Further, multivariate Cox regression revealed that PVH is an independent risk factor for stroke recurrence in AIS patients after adjusting confounding factors. The location of WMH is closely associated with the efficacy of IVT in AIS patients.
登录
查看更多内容
丹参酮 IIA 磺酸钠可提高急性缺血性中风患者 Rt-PA 治疗的有效性，并改善血脑屏障损伤
影响因子：
6.9
作者：
Ji B;Zhou F;Han L;Yang J;Fan H;Li S;Li J;Zhang X;Wang X;Chen X;Xu Y
通讯作者：
Xu Y
影响因子：
11.2
作者：
Parsons, MW;Barber, PA;Davis, SM
通讯作者：
Davis, SM
影响因子：
5.4
作者：
Shrestha, Isha;Takahashi, Tetsuya;Matsumoto, Masayasu
通讯作者：
Matsumoto, Masayasu
影响因子：
3.2
作者：
Nordahl, CW;Ranganath, C;Jagust, WJ
通讯作者：
Jagust, WJ
影响因子：
9.9
作者：
Kongbunkiat K;Wilson D;Kasemsap N;Tiamkao S;Jichi F;Palumbo V;Hill MD;Buchan AM;Jung S;Mattle HP;Henninger N;Werring DJ
通讯作者：
Werring DJ