特别强调对高龄急性卒中患者的溶栓治疗:来自单一荷兰中心的经验

• 作 者: Van Oostenbrugge R. Hupperts R.M.M. Lodder J. 樊慧婷
• 机 构: Department of Neurology University Hospital Maastricht PO Box 5800 6202 AZ Maastricht Netherlands,
• 出 处: 世界核心医学期刊文摘(神经病学分册)
• 发表日期: 2006年08期
• 关键词: 急性卒中 脑内出血 预后良好

The aim of this study was to describe the clinical experience in 184 consecutive stroke patients first- ever treated with recombinant tissue plasminogen activator (rt- PA) at a single Dutch centre, with special emphasis on results among the very old. Outcome parameters were the modified Rankin scale (mRs) at 3 months and symptomatic intracranial haemorrhage (SICH). Outcome was related to age. A total of 184 patients were treated of whom 45 were 80 years of age or older (24% ). Sixty two (45% ) of 139 patients < 80 years of age and 12 (27% ) of 45 patients ≥ 80 years of age had a favourable outcome defined as an mRs score of 0 or 1 (OR 2.21; 95% CI: 1.06 to 4.46). There was a good outcome (mRs score ≤ 2) in 88 (63% ) and 16 (36% ) patients, respectively (OR 3.13; 95% CI: 1.55 to 6.30). SICH was observed in four of 139 (2.9% ) patients < 80 years of age and in five of 45 (11.1% ) patients ≥ 80 years of age (OR 4.22; 95% CI: 1.08 to 16.46). The results of this study underline the uncertainty regarding the risk/benefit ratio of rt- PA treatment in acute stroke in patients over 80 years of age.

The aim of this study was to describe the clinical experience in 184 consecutive stroke patients first-ever treated with recombinant tissue plasminogen activator (rt-PA) at a single Dutch center, with special emphasis on results in the very old. Outcome parameters were the modified Rankin scale (mRs) at 3 months and symptomatic intracranial haemorrhage (SICH). A total of 184 patients were treated of whom 45 were 80 years of age or older (24%). Sixty two (45% ) of 139 patients <80 years of age and 12 (27%) of 45 patients ≥ 80 years of age had a favourous outcome defined as an mRs score of 0 or 1 (OR 2.21; 95% CI: 1.06 to 4.46). There (OR 3.13; 95% CI: 1.55 to 6.30). SICH was observed in four of 139 (2.9%) patients, with a good outcome (mRs score ≤ 2) in 88 <80 years of age and in five of 45 (11.1%) patients ≥ 80 years of age (OR 4.22; 95% CI: 1.08 to 16.46). The results of this study underline the un certainty regarding the risk / benefit ratio of rt-PA treatment in acute stroke in patients over 80 years of age.