脑梗死溶栓后24小时内抗血小板治疗对血栓、出血状态的影响及其机制

批准号:
81471199
项目类别:
面上项目
资助金额:
70.0 万元
负责人:
杨杰
依托单位:
学科分类:
H0906.脑血管结构、功能异常及相关疾病
结题年份:
2018
批准年份:
2014
项目状态:
已结题
项目参与者:
邹建军、周俊山、王晓云、蔺昕、赵艳霞、时建铨、刘宇恺、吴亮、张红
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中文摘要
静脉溶栓是急性脑梗死确证有效的首要治疗措施,溶栓后24h内发生血管再闭塞是较多患者面临的重大临床问题。文献报道及我们的前期研究显示溶栓后血小板的持续激活聚集是血管再闭塞的关键因素之一,故探讨溶栓后24h内抗血小板治疗对血栓、出血状态的影响及其机制,对防治脑梗死溶栓后血管再闭塞或脑出血非常重要,但目前未见脑梗死溶栓后24h内抗血小板治疗对血栓、出血状态影响及其机制的系统研究。综上,我们提出假说:脑梗死溶栓后24h内血栓、出血状态异常是血管再闭塞或脑出血的重要机制之一,可能存在安全有效的早期抗血小板治疗时机。本研究基于前期研究基础,采用脑梗死溶栓兔的实验研究和脑梗死溶栓患者的观察研究,利用多种检测手段,系统研究脑梗死溶栓后24h内抗血小板治疗对血栓、出血状态的影响及其机制,为及时加用抗血小板治疗奠定理论与实验依据,对降低脑梗死静脉溶栓患者的死亡和残疾风险具有重要意义。
英文摘要
Intravenous thrombolysis is one of the confirmed effective treatment for acute brain infarction, but there are still cerebrovascular reocclusions occurred in some patients within 24h after thrombolysis. Because the activation and agrregation of platelet is one of the key factors for cerebrovascular reocclusion, study on the role and mechanism of antipletelet treatment within 24h after thrombolysis for brain infarction on the status of thrombosis and bleeding is of great imporrtance for prevention and treatment of cerebrovascular reocclusion or cerebral hemorrhage. Recent studies showed that antiplatelet treatment prior to intravenous thrombolysis increased the risk of cerebral hemorrhage, but significantly reduced the risk of cerebrovascular reocclusion, which reduces the rate of death and disability in patients with brain infarction. Till now, there is no studies on the role and mechanism of antipletelet treatment within 24h after thrombolysis for brain infarction on the status of thrombosis and bleeding. Therefore, we propose the hypothesis: the abnormal status of thrombosis and bleeding is one of the key mechanisms for cerebrovascular reocclusions or cerebral haemorrhage; there may be a safe and effective antiplatelet treatment within the 24h after thrombolysis. Based on our previous studies, using experimental study in rabbits with brain infarction and cohort study in patients with brain infarction, employing various means of evaluating the status of thrombosis and bleeding, this study will systematically explore the role and mechanism of antipletelet treatment within 24h after thrombolysis for brain infarction. This study will provide some theoretical and experimental evidence on timely addition of antiplatelet therapy after thrombolysis, and which has important clinical significance for reduceing the risk of death and disability of patients with brain infarction.
本研究基于前期研究基础,采用脑梗死溶栓兔的实验研究和脑梗死溶栓患者的观察研究,利用多种检测手段,系统研究脑梗死溶栓后24h内抗血小板治疗对血栓、出血状态的影响及其机制。本研究主要结果:(1)静脉溶栓前抗血小板治疗可以降低溶栓后24h内血小板聚集功能,有改善脑血管再通的趋势,但并不增加溶栓后出血风险。(2)脑梗死兔静脉溶栓后24小时内抗血小板治疗可以降低溶栓后24h内血小板聚集功能,可以改善脑血管再通,但并不增加脑梗死兔溶栓后出血风险。本研究主要结果为临床脑梗死溶栓患者24小时内及时加用抗血小板治疗奠定理论与实验依据,对降低脑梗死患者的死亡和残疾风险具有重要意义。
期刊论文列表
专著列表
科研奖励列表
会议论文列表
专利列表
DOI:10.3969/j.issn.1672-5921.2016.04.009
发表时间:2016
期刊:中国脑血管病杂志
影响因子:--
作者:杭景;耿丛;张羽乔;陆敏;周峰;杨杰
通讯作者:杨杰
Current status of intravenous tissue plasminogen activator dosage for acute ischaemic stroke: an updated systematic review.
急性缺血性卒中静脉注射组织纤溶酶原激活剂剂量的现状:更新的系统评价
DOI:10.1136/svn-2017-000112
发表时间:2018-03
期刊:Stroke and vascular neurology
影响因子:5.9
作者:Wang X;You S;Sato S;Yang J;Carcel C;Zheng D;Yoshimura S;Anderson CS;Sandset EC;Robinson T;Chalmers J;Sharma VK
通讯作者:Sharma VK
Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time.
参与 ENCHANTED 试验对减少就诊至就针时间的积极影响
DOI:10.1038/s41598-017-14164-8
发表时间:2017-10-26
期刊:Scientific reports
影响因子:4.6
作者:Yang J;Wang X;Yu JP;Hang J;Lavados P;Robinson T;Arima H;Lindley RI;Anderson CS;Chalmers J
通讯作者:Chalmers J
Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry
华东地区缺血性脑卒中概况及一年转归:南京市第一医院脑卒中登记中心
DOI:10.1016/j.jstrokecerebrovasdis.2015.08.032
发表时间:2016-01-01
期刊:JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
影响因子:2.5
作者:Shi, Guo-mei;Zhang, Ying-dong;Zhou, Jun-shan
通讯作者:Zhou, Jun-shan
circRNA29254—miR-29a-3p—CYP2C19轴在脑梗死氯吡格雷抵抗中的作用及机制
- 批准号:82171295
- 项目类别:面上项目
- 资助金额:54万元
- 批准年份:2021
- 负责人:杨杰
- 依托单位:
MiR-150-5p通过调控GP IIb/IIIa受体改善替罗非班疗效的机制研究
- 批准号:81870940
- 项目类别:面上项目
- 资助金额:61.0万元
- 批准年份:2018
- 负责人:杨杰
- 依托单位:
国内基金
海外基金
