Body temperature and outcome after stroke thrombolysis
Body temperature and outcome after stroke thrombolysis
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DOI：
10.1111/j.1600-0404.2006.00596.x
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发表时间：
2006-07-01
影响因子：
3.5
通讯作者：
Thijs, V.
中科院分区：
文献类型：
--
作者：
Ernon, L.;Schrooten, M.;Thijs, V.
目的：我们研究基线体温和卒中后体温升高是否对静脉组织纤溶酶原激活剂（IV tPA）溶栓治疗的结果产生不利影响。方法-通过计算相对于入院时体温（AUC（BL））和相对于37 ℃标准值（AUC（37））的体温随时间曲线的曲线下面积，描述IV tPA治疗后前24小时内体温的变化。温度参数与功能结局相关。结果：100例连续患者的国立卫生研究院卒中量表基线中位数为16（四分位数范围11-21），34例患者对tPA有良好反应。与tPA治疗后结局良好的患者相比，结局不良的患者体温升高更为重要（+1 ℃ vs +0.6 ℃，P = 0.02），尽管基线T相似，但AUC（BL）更高（9.79 vs 5.36，P = 0.027），并且相对于基线更频繁地显示体温过高（82% vs 56%，P = 0.011）。校正基线特征后，相对于基线，体温过高的存在与溶栓后良好结局的几率降低相关（OR 0.34，95%CI 0.10-0.95，P = 0.040）。结论：静脉溶栓后24小时内相对于基线体温的高热与不良结局相关。
Aims - We studied whether baseline body temperature and temperature increases after stroke adversely affect outcome after thrombolysis with intravenous tissue plasminogen activator (IV tPA). Methods - The evolution of body temperature in the first 24 h after treatment with IV tPA was described by calculating the area under the curve of the temperature over time plot relative to temperature at admission (AUC(BL)) and relative to a standard value of 37 degrees C (AUC(37)). Temperature parameters were related to functional outcome. Results - The median baseline National Institutes of Health Stroke Scale of 100 consecutive patients was 16 (interquartile range 11-21) and 34 patients had a favourable response to tPA. Patients with an unfavourable outcome had a more important temperature elevation than patients who had a favourable outcome after tPA (+1 degrees C vs +0.6 degrees C, P = 0.02), despite similar baseline T and had a higher AUC(BL) (9.79 vs 5.36, P = 0.027) and more frequently showed hyperthermia relative to baseline (82% vs 56%, P = 0.011). After adjustment for baseline characteristics, the presence of hyperthermia relative to baseline was associated with a reduced odds of good outcome after thrombolysis (OR 0.34, 95% CI 0.10-0.95, P = 0.040). Conclusion - Hyperthermia relative to baseline temperature in the 24 h after intravenous thrombolysis is associated with an unfavourable outcome.