医学
纤溶酶原激活剂
溶栓
组织纤溶酶原激活剂
内科学
重组组织纤溶酶原激活剂
纤维蛋白原
心脏病学
血压
麻醉
冲程(发动机)
外科
链激酶
胃肠病学
纤溶酶原激活物抑制剂-1
心肌梗塞
作者
Ryo Ohtani,Michikazu Nakamura,Shinsuke Nirengi,Osamu Kawakami,Jumpei Togawa,Kento Doi,Makoto Sainouchi,Yasuhiro Kuwata,Masaki Takata,Yuichi Masuda,Ryota Matsunari,Kiyoaki Takeda,Tetsuya Tsukahara,Naoki Sakane
出处
期刊:Journal of Stroke & Cerebrovascular Diseases
日期:2019-07-01
卷期号:28 (7): 1979-1986
被引量:2
标识
DOI:10.1016/j.jstrokecerebrovasdis.2019.03.035
摘要
Abstract Background Hemorrhagic infarction (HI) is among the most severe complications that can occur following the administration of intravenous recombinant tissue plasminogen activator (rt-PA). In the present study, we aimed to determine the optimal cut-off points of blood pressure (BP) for HI after rt-PA treatment, and to compare our findings with those for other prediction models. Methods We analyzed data from 109 consecutive patients with stroke treated at our hospital between 2009 and 2016. HI was confirmed via computed tomography or magnetic resonance imaging. Patients were classified into a symptomatic HI group, an asymptomatic HI group, and a non-HI group. BP was measured on admission and before rt-PA treatment. Glucose Race Age Sex Pressure Stroke Severity (GRASPS) and Totaled Health Risks in Vascular Events (THRIVE) scores were also calculated. Receiver operating characteristic (ROC) analysis was used to determine factors associated with symptomatic and asymptomatic HI. Results Among the 109 total patients, 25 patients developed symptomatic HI, while 22 patients developed asymptomatic HI. ROC analysis for predicting symptomatic and asymptomatic HI revealed that the area under the curve for pretreatment systolic BP (SBP) was .88 (95% confidence interval[CI]: .83-.94), while those for GRASPS and THRIVE scores were .75 (95% CI: .66-.85) and .69 (95% CI: .59-.79), respectively. We identified an optimal cut-off point of 160 mm Hg (sensitivity: 82.3%; specificity: 76.6%; diagnostic accuracy: 80.0%; positive predictive value: 76.6%; negative predictive value: 82.5%). Conclusions Pre-treatment SBP may be a simple predictor of symptomatic and asymptomatic HI in patients with stroke undergoing rt-PA treatment.
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