급성허혈성뇌졸중환자에서정맥내r-tPA 사용후뇌출혈발생에영향을미치는인자
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Background: Recombinant tissue plasminogen activator (r-tPA) is an established treatment for acute ischemicstroke. But hemorrhagic transformation (HT) is critical complication of r-tPA treatment. In this study, the authorsattempted to identify the possible predictive factors of HT after r-tPA treatment. Methods: We analyzed retrospec-tively the data of 42 patients with acute ischemic stroke who were treated with intravenous r-tPA within 3 hours ofsymptom onset at Chonnam National University Hospital from May 1999 to April 2003. We divided 42 patientsaccording to the presence of hemorrhage, and analyzed predictive factors of HT.Results: Among the 42 patients,12 (28%) had HT (symptomatic ICH in 4). Patients with middle cerebral artery (MCA) territory stroke tended tohave a relatively frequent HT as compared to those with non-MCA territory stroke(p=0.06). There were no signif-icant differences between the two groups in age, sex, past history of stroke, baseline NIHSS score, early ischemicchange on CT, systolic and diastolic blood pressure before r-tPA treatment. Conclusions: There are no critical pre-dictive factors for HT after r-tPA treatment except possibly for the MCA (vs. non-MCA) territory stroke. It maybe necessary to give careful attention in subjects with MCA territory while r-tPA treatment is attempted. 대한뇌졸중학회지제6권제1호2004년5월
Abstract
Background: Recombinant tissue plasminogen activator (r-tPA) is an established treatment for acute ischemicstroke. But hemorrhagic transformation (HT) is critical complication of r-tPA treatment. In this study, the authorsattempted to identify the possible predictive factors of HT after r-tPA treatment. Methods: We analyzed retrospec-tively the data of 42 patients with acute ischemic stroke who were treated with intravenous r-tPA within 3 hours ofsymptom onset at Chonnam National University Hospital from May 1999 to April 2003. We divided 42 patientsaccording to the presence of hemorrhage, and analyzed predictive factors of HT.Results: Among the 42 patients,12 (28%) had HT (symptomatic ICH in 4). Patients with middle cerebral artery (MCA) territory stroke tended tohave a relatively frequent HT as compared to those with non-MCA territory stroke(p=0.06). There were no signif-icant differences between the two groups in age, sex, past history of stroke, baseline NIHSS score, early ischemicchange on CT, systolic and diastolic blood pressure before r-tPA treatment. Conclusions: There are no critical pre-dictive factors for HT after r-tPA treatment except possibly for the MCA (vs. non-MCA) territory stroke. It maybe necessary to give careful attention in subjects with MCA territory while r-tPA treatment is attempted. 대한뇌졸중학회지제6권제1호2004년5월