Delayed increase in infarct volume after cerebral ischemia - Correlations with thrombolytic treatment and clinical outcome
Delayed increase in infarct volume after cerebral ischemia - Correlations with thrombolytic treatment and clinical outcome
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DOI：
10.1161/01.str.30.3.502
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发表时间：
1999-03-01
期刊：
影响因子：
8.3
通讯作者：
von Kummer, R
中科院分区：
文献类型：
--
作者：
Pantano, P;Caramia, F;von Kummer, R
背景和目的-越来越多的实验证据表明，脑缺血性损伤的发展比以前认为的要慢。本研究的目的是：（1）研究缺血性脑卒中患者24 ~ 36小时和7天内CT低密度的演变，（2）评价卒中后6小时内给予溶栓治疗是否影响迟发性梗死的演变;和（3）研究病变体积随时间的变化与临床结果之间可能的相关性，方法：在欧洲急性卒中合作研究1（ECASS 1）的620例患者中，我们选择了450例患者，他们在第1天（CT 1）和第7天（CT 7）的对照CT扫描是可用的。他们被随机分为2组：206名患者接受rtPA治疗，244名患者接受安慰剂治疗。CT 1、CT 7按梗死部位分类，CT低密度区体积按公式A × B × C/2计算。使用动脉间和动脉内变异性的95%置信区间来确定CT 1和CT 7之间是否发生了病变体积的显著变化。在入组时（SSS 0）和第30天（SSS 30）通过斯堪的纳维亚卒中量表（SSS）评估临床严重程度。
Background and Purpose-Growing experimental evidence indicates that the development of cerebral ischemic damage is slower than previously believed. The aims of this work were (1) to study the evolution of CT hypoattenuation between 24 to 36 hours and 7 days in ischemic stroke patients; (2) to evaluate whether thrombolytic treatment given within 6 hours of stroke affects delayed infarction evolution; and (3) to investigate possible correlations between lesion volume changes over time and clinical outcome,Methods-Of 620 patients included in the European Cooperative Acute Stroke Study 1 (ECASS1), we selected 450 patients whose control CT scans at day 1 (CT1) and day 7 (CT7) were available. They had been randomly divided into 2 groups: 206 patients had been treated with rtPA and 244 with placebo. CT1 and CT7 were classified according to the location of the infarct, The volume of CT hypoattenuation was measured using the formula A X B X C/2 for irregular volumes. The 95% confidence interval of inter- and intrarater variability was used to determine whether significant changes in lesion volume had occurred between CT1 and CT7. Clinical severity was evaluated by means of the Scandinavian Stroke Scale (SSS) at entry (SSS0) and at day 30 (SSS30)Results-Mean lesion volumes were significantly (P