@article {Ruecker31作者={迈克尔Ruecker和便雅悯Matosevic和彼得Willeit和马提亚Kirchmayr和亚历山德拉Zangerle迈克尔Knoflach和约翰·Willeit Stefan Kiechl}, title ={开始华法林治疗中风溶栓后需要增加出血风险},体积={79}={1},页面= {31 - 38}= {2012},doi = {10.1212 / WNL。出版商0 b013e31825dcdf0} = {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={目的:溶栓后出血并发症的风险量化对缺血性中风患者华法林(国际标准化比率(I首页NR) < = 1.7),并将这些数据与先前的研究视角。连续方法:共有548名中风患者接受静脉注射重组组织纤溶酶原激活物(rtPA)前瞻性评估和华法林预处理的细节仔细记录。凝血酶原时间{\ textendash}以INR值测定溶栓前6和24小时之后。颅内出血发生在72小时内被CT检查和评估定义根据国家神经疾病和中风研究所的标准。主要的结果变量是症状性颅内和重大系统性流血。结果:548例患者,33(6.0 \ %)和14(2.6 \ %)经验丰富的症状性颅内和重大系统性流血,分别。病人服用华法林,直到一天或一天之前入学(n = 15日平均{\ textpm} SD INR 1.21 0.32 vs 1.01 {\ textpm} {\ textpm} 1.12, p = 0.030)面临着颅内出血的风险约4倍(20.0 vs 5.6 \ \ % %,未经调整优势比[或][95 \ %可信区间(CI)] 4.2 1.1 {\ textendash} 15.7, p = 0.033)。发现类似的年龄调整后,NIH卒中量表得分,和糖尿病(调整或(95 \ % CI) 4.1 1.0 {\ textendash} 16.1, p = 0.044),当专注于任何重大出血(颅内或系统)(未经调整或(95 \ % CI) 4.1 1.3 {\ textendash} 13.6, p = 0.019)。一半的患者流血显示INR超越1.7溶栓后6小时。荟萃分析成果确认但异构(未调整或[95 \ % CI)来自一个随机效应模型,2.31 1.15 {\ textendash} 4.62, p = 0.018, I2 = 58 \ % [11 \ % {\ textendash} 80 \ %])。 Conclusions: Our data suggest a statistically significant and clinically meaningful increase in the risk for symptomatic intracranial and major systemic bleedings among patients with stroke thrombolysis receiving warfarin up to the day of or day before stroke. Neurology{\textregistered} 2012;79:31{\textendash}38 CI=confidence interval; CRP=C-reactive protein; ECASS=European Cooperative Acute Stroke Study; INR=international normalized ratio; mRS=modified Rankin Scale; NIHSS=NIH Stroke Scale; NINDS=National Institute of Neurological Disorders and Stroke; OR=odds ratio; PACS=picture archiving and communication system; PT=prothrombin time; PTT=partial thromboplastin time; rtPA=recombinant tissue plasminogen activator; SITS-MOST=Safe Implementation of Thrombolysis in Stroke{\textendash}Monitoring Study}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/79/1/31}, eprint = {//www.ez-admanager.com/content/79/1/31.full.pdf}, journal = {Neurology} }