静脉溶栓后的远隔出血效应幻灯片.pptxVIP

Stroke. 2016 Aug;47(8) 2016-8-18 Quan Dong Background Intracerebral hemorrhage (ICH) is the most serious complication of intravenous thrombolysis with recombinant tissue-type plasminogen activator (IV-r-tPA) in patients with ischemic stroke. Remote Parenchymal Hemorrhages（rPH） has an incidence of 1.3 to 3.7% and is associated with a poor outcome Little is known about the frequency, associated risk factors, and prognosis of rPH.The aim of this study was to analyze frequency, risk factors, clinical and radiological features, and prognosis of patients with rPH. Methods Methods (Study Population) Methods (Clinical Assessment) The following variables were recorded: Demographics traditional vascular risk factors liver disease previous medication time from the onset of symptoms to the administration of IV-r-tPA NIHSSscore at admission and 24 to 36 hours hypertensive episodes and hyperthermia ; baseline laboratory data type of hemorrhagic complication , number and localization rPH; TOAST symptomatic ICH functional outcome and mortality were assessed at 3 months (Rankin scale score ≤2). 人口学特征 血管危险因素 肝脏疾病 既往用药 溶栓时间 NIHSS评分 血压及体温 基线实验室数据 出血并发症类型，rPH部位和数量 TOAST分型 症状性脑出血 功能预后 Methods (Radiological Assessment) MRI 1.5T T1 T2 FLAIR T2* DWI RSI （ recent silent ischemia ） Leukoaraiosis CMB（ cerebral microbleeds ） CSS（ cortical superficial siderosis ） Vascular malformations Methods (Statistical Analysis) ischemic stroke IV-r-tPA rPH group Single or multiple rPH rPH + concomitant PH PH group without any rPH or PH No bleeding indicates hemorrhagic infarct Methods (Statistical Analysis) Statistical Analysis contingency tables with the χ 2 or the Fisher exact test Student t test for quantitative variables Mann–Whitney U test multiple logistic regression analysis Results Distribution of Bleeding Complications Risk Factors Clinical and Radiological Features Risk Factors in the Whole Sample Demographic variables, traditional vas