初发症状性脑梗死患者接受静脉重组组织型纤溶酶原激活剂治疗后的认知和功能预后

• 作 者: Nys G.M.S. Van Zandvoort M.J.E. Algra A. 周永
• 机 构: Psychological Laboratory (17.24B) HelmholtzInstitute Utrecht University Heidelberglaan 2 3584 CS Ut
• 出 处: 世界核心医学期刊文摘(神经病学分册)
• 发表日期: 2006年Z1期
• 关键词: 初发症状 神经心理学 活动指数 多变量 比值比

Objective: To examine whether intravenous recombinant tissue plasminogen activator (rt-PA) treatment given in the acute phase of ischaemic stroke has a favourable effect on cognitive and functional outcome at six months post-stroke. Methods: The present study included 92 patients with a first-ever symptomatic infarct, of whom 25 (27 %) were subjected to rt-PA treatment in the first three hours post-stroke. Multivariate logistic regression analyses adjusted for stroke severity, education, age, and sex were performed to examine whether rt-PA treatment influenced cognitive outcome (assessed with a neuropsychological examination covering 7 cognitive domains), basic ADL independence (modified Barthel Index ≥19), and instrumental ADL independence (Frenchay Activities Index ≥15) after six months. Results: The adjusted odds ratio for intact cognition was 1.0 (95%CI 0.2 to 4.3), that for basic ADL outcome 13.5 (95%CI 1.4 to 129.4) and for instrumental ADL 7.1 (95%CI 1.2 to 42.2). Conclusion: Our findings suggest that rt-PA treatment is associated with a favourable basic and instrumental ADL outcome, but not with a beneficial cognitive outcome after 6 months.

Objective: To examine whether intravenous recombinant tissue plasminogen activator (rt-PA) treatment given in the acute phase of ischaemic stroke has a favourable effect on cognitive and functional outcome at six months post-stroke. Methods: The present study included 92 patients with a first-ever symptomatic infarct, of whom 25 (27%) were subjected to rt-PA treatment in the first three hours post-stroke. Multivariate logistic regression analyzes adjusted for stroke severity, education, age, and sex were performed to examine whether rt -PA treatment influenced cognitive outcome (assessed with a neuropsychological examination covering 7 cognitive domains), basic ADL independence (modified Barthel Index ≥19), and instrumental ADL independence (Frenchay Activities Index ≥15) after six months. Results: The adjusted odds ratio for intact cognition was 1.0 (95% CI 0.2 to 4.3), that for basic ADL outcome 13.5 (95% CI 1.4 to 129.4) and for instrumental ADL 7.1 (95% CI 1.2 to 42.2) : Our findings suggest that rt-PA treatment is associated with a favourable basic and instrumental ADL outcome, but not with a beneficial cognitive outcome after 6 months.