- 作者：Petr Aulicky ; Alej ; ro Rabinstein ; Raymond C.S. Seet ; Jiri Neumann ; Robert Mikulik
- 关键词：Acute ischemic stroke ; efficacy of treatment ; safety of treatment ; thrombolysis ; tissue plasminogen activator dose
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：November, 2013
- 年：2013
- 卷：22
- 期：8
- 页码：1293-1297
- 全文大小：125 K
Background
The safety and efficacy of low- and high-dose intravenous tissue plasminogen activator (t-PA) for the treatment of acute ischemic stroke are poorly understood. In this multicenter study, we examined the relationships between different doses of t-PA and outcome.Methods
Between 2006 and 2010, patients were enrolled if聽they were treated with t-PA on the basis of estimated body weight and on the subsequent availability of actual body weight. Based on the actual weight, patients were聽divided into lower (<0.85 mg/kg), standard (0.85-0.95 mg/kg), and higher (>0.95聽mg/kg) t-PA dose groups. Differences in the outcomes of these groups were compared in terms of functional recovery (modified Rankin Scale [mRS] 0-1) at 3聽months and the incidence of parenchymal hemorrhages on follow-up computed tomographic scans.
Results
This cohort study included 272 patients: 171 (63%) patients received the standard t-PA dose, 62 (23%) a lower dose, and 39 (14%) a higher dose. At 3 months, 51% of the standard dose patients achieved a mRS score of 0 to 1, compared with 50% in the lower dose and 44% in the higher dose groups. Parenchymal hemorrhage occurred in 4.7%, 6.5%, and 7.7% of patients in standard, lower, and higher dose groups, respectively. Compared with standard dose groups, no significant differences in functional recovery and parenchymal hemorrhage were observed in the lower and higher dose groups.
Conclusions
In clinical practice, the actual dose of聽t-PA often differs from the recommended dose of 0.9 mg/kg, but this has no significant impact on the outcome after t-PA treatment.