中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (02): 192-198.DOI: 10.3969/j.issn.1673-5765.2017.02.020
崔颖,佟旭,王伊龙,郑华光,曹亦宾
收稿日期:
2016-09-26
出版日期:
2017-02-20
发布日期:
2017-02-20
通讯作者:
曹亦宾 yibin07@sina.com
基金资助:
2016年北京市科学技术委员会“首都临床特色应用研究”专项课题(Z161100000516079)
Received:
2016-09-26
Online:
2017-02-20
Published:
2017-02-20
摘要:
尽管多数急性缺血性卒中患者经阿替普酶静脉溶栓治疗后症状有所缓解,仍有相当一部 分患者经历早期神经功能恶化(early neurological deterioration,END),症状进一步加重。目前学术界 对于END的定义尚未统一,因此导致END的发生率不尽相同。关于END确切病因、危险因素以及相关 病理生理机制仍是学术界讨论的热点。END的发生强烈提示患者3个月预后不良。本文就以上内容进 行综述。
崔颖,佟旭,王伊龙,郑华光,曹亦宾. 阿替普酶静脉溶栓后发生早期神经功能恶化的研究进展[J]. 中国卒中杂志, 2017, 12(02): 192-198.
CUI Ying, TONG Xu, WANG Yi-Long, et al.. Study Progress of Early Neurological Deterioration Following Intravenous Thrombolysis with Alteplase[J]. Chinese Journal of Stroke, 2017, 12(02): 192-198.
1 卫生部新闻办公室. 第三次全国死因调查主要情况[J].中国肿瘤,2008,17:344-345.2 Yang G,Wang Y,Zeng Y,et al. Rapid healthtransition in China,1990-2010:findings from theGlobal Burden of Disease Study 2010[J]. Lancet,2013,381:1987-2015.3 Tissue plasminogen activator for acute ischemicst roke. The National Institute of NeurologicalDisorders and Stroke rt-PA Stroke Study Group[J]. NEngl J Med,1995,333:1581-1587.4 Hacke W,Kaste M,Bluhmki E,et al. Thrombolysiswith alteplase 3 to 4. 5 hours after acute ischemicstroke[J]. N Engl J Med,2008,359:1317-1329.5 Davis SM,Donnan GA,Parsons MW,et al. Effectsof alteplase beyond 3 h after stroke in the EchoplanarImaging Thrombolytic Evaluation Trial (EPITHET):aplacebo-controlled randomised trial[J]. Lancet Neurol,2008,7:299-309.6 Wa h lg r en N,Ahmed N,Dáva l o s A,e t a l .Thrombolysis with alteplase 3-4. 5 h after acuteischaemic stroke (SITS-ISTR):an observationalstudy[J]. Lancet,2008,372:1303-1309.7 Saver JL,Altman H. Relationship between neurologicdeficit severity and final functional outcome shiftsand strengthens during first hours after onset[J].Stroke,2012,43:1537-1541.8 Dávalos A,Toni D,Iweins F,et al. Neurologicaldeterioration in acute ischemic stroke:potentialpredictors and associated factors in the Europeancooperative acute stroke study (ECASS) Ⅰ[J]. Stroke,1999,30:2631-2636.9 Kim JM,Moon J,Ahn SW,et al. The etiologies ofearly neurological deterioration after thrombolysisand risk factors of ischemia progression[J]. J StrokeCerebrovasc Dis,2016,25:383-388.10 Zinkstok SM,Beenen LF,Majoie CB,et al. Earlydeterioration after thrombolysis plus aspirin in acutestroke:a post hoc analysis of the Antiplatelet Therapyin Combination with Recombinant t-PA Thrombolysisin Ischemic Stroke trial[J]. Stroke,2014,45:3080-3082.11 Hacke W,Kaste M,Fieschi C,et al. Randomiseddouble-blind placebo-controlled trial of thrombolytictherapy with intravenous alteplase in acute ischaemicstroke (ECASS Ⅱ). Second European-AustralasianAcute Stroke Study Investigators[J]. Lancet,1998,352:1245-1251.12 Wa h lg r en N,Ahmed N,Dáva l o s A,e t a l .Thrombolysis with alteplase for acute ischaemic strokein the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST):an observationalstudy[J]. Lancet,2007,369:275-282.13 Mor i M,Naganuma M,Okada Y,et al. Earlyneurological deterioration within 24 hours afterintravenous rt-PA therapy for stroke patients:theStroke Acute Management with Urgent Risk FactorAssessment and Improvement rt-PA Registry[J].Cerebrovasc Dis,2012,34:140-146.14 Awadh M,MacDougall N,Santosh C,et al. Earlyrecurrent ischemic stroke complicating intravenousthrombolysis for stroke:incidence and associationwith atrial fibrillation[J]. Stroke,2010,41:1990-1995.15 Nanri Y,Yakushiji Y,Hara M,et al. Stroke scaleitems associated with neurologic deterioration within24 hours after recombinant tissue plasminogenactivator therapy[J]. J Stroke Cerebrovasc Dis,2013,22:1117-1124.16 Simonsen CZ,Schmitz ML,Madsen MH,et al. Earlyneurological deterioration after thrombolysis:Clinicaland imaging predictors[J]. Int J Stroke,2016,11:776-782.17 Siegler JE,Martin-Schild S. Early neurologicaldeterioration (END) after stroke:the END dependson the definition[J]. Int J Stroke,2011,6:211-212.18 Seners P,Turc G,Oppenheim C,et al. Incidence,causes and predictors of neurological deteriorationoccurring within 24 h following acute ischaemicstroke:a systematic review with pathophysiologicalimplications[J]. J Neurol Neurosurg Psychiatry,2015,86:87-94.19 Wardlaw JM,Murray V,Berge E,et al. Recombinanttissue plasminogen activator for acute ischaemicstroke:an updated systematic review and metaanalysis[J]. Lancet,2012,379:2364-2372.20 Strbian D,Sairanen T,Meretoja A,et al. Patientoutcomes from symptomatic intracerebral hemorrhageafter stroke thrombolysis[J]. Neurology,2011,77:341-348.21 Tong X,George MG,Yang Q,et al. Predictorsof in-hospital death and symptomatic intracranialhemorrhage in patients with acute ischemic stroketreated with thrombolytic therapy:Paul CoverdellAcute Stroke Registry 2008-2012[J]. Int J Stroke,2014,9:728-734.22 Desilles JP,Meseguer E,Labreuche J,et al. Diabetesmellitus,admission glucose,and outcomes afterstroke thrombolysis:a registry and systematicreview[J]. Stroke,2013,44:1915-1923.23 Bentley P,Ganesalingam J,Carlton Jones AL,et al.Prediction of stroke thrombolysis outcome using CTbrain machine learning[J]. Neuroimage Clin,2014,4:中国卒中杂志 2017年2月 第12卷 第2期 197635-640.24 Dubey N,Bakshi R,Wasay M,et al. Early computedtomography hypodensity predicts hemorrhage afterintravenous tissue plasminogen activator in acuteischemic stroke[J]. J Neuroimaging,2001,11:184-188.25 Whiteley WN,Emberson J,Lees KR,et al. Riskof intracerebral haemorrhage with alteplase afteracute ischaemic stroke:a secondary analysis ofan individual patient data meta-analysis[J]. LancetNeurol,2016,15:925-933.26 Treadwell SD,Thanvi B. Malignant middle cerebralartery (MCA) infarction:pathophysiology,diagnosisand management[J]. Postgrad Med J,2010,86:235-242.27 Battey TW,Karki M,Singhal AB,et al. Brain edemapredicts outcome after nonlacunar ischemic stroke[J].Stroke,2014,45:3643-3648.28 Kobayashi M,Tanaka R,Yamashiro K,et al. Preexistingmobile cardiac thrombus and the risk of earlyrecurrent embolism after intravenous thrombolysis:acase report[J]. J Stroke Cerebrovasc Dis,2015,24:e161-e163.29 Kamal H,Mowla A,Farooq S,et al. Recurrentischemic stroke can happen in stroke patients veryearly after intravenous thrombolysis[J]. J Neurol Sci,2015,358:496-497.30 Kahles T,Mono ML,Heldner MR,et al. Repeatedintravenous thrombolysis for early recurrent stroke:challenging the exclusion criterion[J]. Stroke,2016,47:2133-2135.31 Jung S,Schindler K,Findling O,et al. Adverseeffect of early epileptic seizures in patients receivingendovascular therapy for acute stroke[J]. Stroke,2012,43:1584-1590.32 Alvarez V,Rossetti AO,Papavasileiou V,et al. Acuteseizures in acute ischemic stroke:does thrombolysishave a role to play?[J]. J Neurol,2013,260:55-61.33 Seners P,Turc G,Tisserand M,et al. Unexplainedearly neurological deterioration after intravenousthrombolysis:incidence,predictors,and associatedfactors[J]. Stroke,2014,45:2004-2009.34 Tisserand M,Seners P,Turc G,et al. Mechanismsof unexplained neurological deterioration afterintravenous thrombolysis[J]. Stroke,2014,45:3527-3534.35 Reuter B,Gumbinger C,Sauer T,et al. Intravenousthrombolysis for acute ischaemic stroke in theelderly:data from the Baden-Wuerttemberg StrokeRegistry[J]. Eur J Neurol,2016,23:13-20.36 Mione G,Ducrocq X,Thilly N,et al. Outcomeof intravenous recombinant tissue plasminogenactivator for acute ischemic stroke in patients agedover 80 years[J]. Geriatr Gerontol Int,2016,16:843-849.37 Alvarez-Sabín J,Mol ina CA,Montaner J,etal. Effects of admission hyperglycemia on strokeoutcome in reperfused tissue plasminogen activator--treated patients[J]. Stroke,2003,34:1235-1241.38 Ennis SR,Keep RF. Effect of sustained-mild andtransient-severe hyperglycemia on ischemia-inducedblood-brain barrier opening[J]. J Cereb Blood FlowMetab,2007,27:1573-1582.39 Hou Q,Zuo Z,Michel P,et al. Influence of chronichyperglycemia on cerebral microvascular remodeling:an in vivo study using per fusion computedtomography in acute ischemic stroke patients[J].Stroke,2013,44:3557-3560.40 Morita N,Harada M,Uno M,et al. Evaluation ofinitial diffusion-weighted image findings in acutestroke patients using a semiquantitative score[J].Magn Reson Med Sci,2009,8:47-53.41 Haeusler KG,Gerischer LM,Vatankhah B,et al.Impact of hospital admission during nonworkinghours on patient outcomes after thrombolysis forstroke[J]. Stroke,2011,42:2521-2525.42 Whiteley WN,Slot KB,Fernandes P,et al. Riskfactors for intracranial hemorrhage in acute ischemicstroke patients treated with recombinant tissueplasminogen activator:a systematic review and metaanalysisof 55 studies[J]. Stroke,2012,43:2904-2909.43 Strbian D,Meretoja A,Putaala J,et al. Cerebraledema in acute ischemic stroke patients treated withintravenous thrombolysis[J]. Int J Stroke,2013,8:529-534.44 Tiainen M,Meretoja A,Strbian D,et al. Bodytemperature,blood infection parameters,andoutcome of thrombolysis-treated ischemic strokepatients[J]. Int J Stroke,2013,8:632-638.45 Cermak J,Key NS,Bach RR,et al. C-reactiveprotein induces human peripheral blood monocytes tosynthesize tissue factor[J]. Blood,1993,82:513-520.46 Villemure C,Bushnell MC. Mood inf luencessupraspinal pain processing separately f romattention[J]. J Neurosci,2009,29:705-715.47 Baizabal-Carvallo JF,Alonso-Juarez M,Samson Y.Clinical deterioration following middle cerebral arteryhemodynamic changes after intravenous thrombolysisfor acute ischemic stroke[J]. J Stroke Cerebrovasc Dis,2014,23:254-258.48 We i X E,Zhao YW,Lu J,et a l . Timi ng ofrecanalization and outcome in ischemic-stroke198 Chin J Stroke, Feb 2017, Vol 12, No.2patients treated with recombinant tissue plasminogenactivator[J]. Acta Radiol,2015,56:1119-1126.49 Kim YD,Lee JH,Jung YH,et al. Effect of warfarinwithdrawal on thrombolytic treatment in patients withischaemic stroke[J]. Eur J Neurol,2011,18:1165-1170.50 Lou M,Selim M. Does body weight influence theresponse to intravenous tissue plasminogen activatorin stroke patients?[J]. Cerebrovasc Dis,2009,27:84-90.51 Kim JT,Park MS,Chang J,et al. Proximal arterialocclusion in acute ischemic stroke with low NIHSSscores should not be considered as mild stroke[J].PLoS One,2013,8:e70996. |
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