Clinical Signs of Recanalization in Stroke中风血管再通的临床指征

A small study in the US suggests that neurologic improvement with concurrent decline in systolic blood pressure of 20 mm Hg or greater after intravenous tissue plasminogen activator may be a clinical sign of recanalization in stroke. The study included 17 patients who were treated with intravenous tissue plasminogen activator, had pretreatment and 24-hour magnetic resonance angiographic scans, National Institutes of Health Stroke Scale scores at those times, and proximal middle cerebral artery occlusion demonstrated prior to treatment. At 24 hours after thrombolysis, neurologic improvement with concurrent decline in systolic blood pressure of 20 mm Hg or greater was seen in 4 patients with partial recanalization, 4 patients with complete recanalization, and none of the patients with no recanalization. Blood pressure drop or neurologic improvement alone is not good predictor of recanalization. Source: http://archneur.jamanetwork.com/美国一项小型研究提示，静脉注射组织型纤溶酶原激活剂后神经功能改善且同时收缩压下降20毫米汞柱或更多可能是中风后血管再通的临床指征。这项研究包括经静脉注射组织型纤溶酶原激活剂治疗的17例患者，有治疗前和24小时磁共振血管造影扫描，国立卫生研究院卒中评分，并于治疗前证实有大脑中动脉近端闭塞。在溶栓治疗后24小时，神经功能改善且同时收缩压下降20毫米汞柱以上出现于4例部分再通，4例完全再通，而无一例于没有再通患者。仅血压下降或神经功能改善并非再通的良好预测指标。来源：http://archneur.jamanetwork.com/