Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler
Yıl: 2018 Cilt: 55 Sayı: 1 Sayfa Aralığı: 80 - 83 Metin Dili: Türkçe DOI: 10.29399/npa.22664 İndeks Tarihi: 26-09-2019
Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler
Öz: Amaç: Bu çalışmada, İntravenöz rekombinant doku plazminojenaktivatörü (İV rt-PA) ile tedavi edilen akut inme hastalarında erkennörolojik iyileşme (ENİ) ile ilişkili faktörleri ve ENİ’nin üç ay sonrakisonlanımla ilişkisini saptamak amaçlanmıştır.Yöntem: Eskişehir Osmangazi Üniversitesi Tıp Fakültesi inme merkezindeŞubat 2009 – Aralık 2016 tarihleri arasında ilk 4,5 saat içinde İV rt-PAuygulanan akut iskemik inmeli hastalar çalışmaya dahil edildi. ENİ,tedaviden 24 saat sonra National Institutes of Health Stroke Scale (NIHSS)skorunun 0 ya da 1 olması ya da tedavi öncesi skor ile karşılaştırıldığında≥8 puanlık bir iyileşme olması olarak belirlendi. Hastaların tedavi sonrası3. aydaki sonlanımları modified Rankin Scale (mRS) skoru ile belirlenmişolup, mRS skoru 0–1 ise ‘çok iyi sonlanım’ olarak değerlendirildi.Bulgular: Çalışmaya dahil olan 355 hastanın %43,9’unda ENİ gözlendi.ENİ gözlenen hastaların %80,1’inde, gözlenmeyenlerinse %15,6’sında3. ayda çok iyi sonlanım saptandı (p<0,001). ENİ gözlenen hastalargözlenmeyenlere göre daha genç (p=0,025) olup, daha düşük NIHSSskorlarına (p=0,027) ve daha yüksek ASPECT skorlarına (p=0,008) sahipti.Yine, ENİ gözlenen grubun başvuru anındaki serum glukoz düzeyleri dahadüşük olup (p<0,001), bu hastalarda diabetes mellitus ve hipertansiyonöyküsü ve hiperdens arter bulgusu saptanma oranı daha azdı (sırasıylap=0,001, p=0,024 ve p<0,001). Son olarak; çoklu regresyon analizinde isebaşvuru serum glukoz düzeyi ve hiperdens arter işareti ile ENİ arasındaanlamlı ilişki saptandı.Sonuç: İV rt-PA uygulanan akut inme hastalarında, ENİ ve üç ay sonrakiçok iyi sonlanım arasında anlamlı ilişki mevcuttur. Bu yüzden, özellikleENİ ile ilişkisi saptanmış olan bir başvuruda, serum glukoz düzeyi, NIHSSskoru, ASPECT skoru ve hiperdens arter işareti varlığı gibi faktörlerinyönetimi ve tedavi stratejilerinin bunlara göre değerlendirmesi, akutiskemik inmede daha iyi bir sonlanımın sağlanması açısından önemtaşımaktadır.
Anahtar Kelime: Konular:
Factors Associated with Early Recovery after Intravenous Thrombolytic Therapy in Acute Ischemic Stroke
Öz: Introduction: In this study, we aimed to identify the factors associated with early neurological improvement (ENI) in acute stroke patients treated with intravenous recombinant tissue plasminogen activator (IV rt-PA), and to determine the association between ENI and outcomes at 3 months after stroke. Methods: Patients with acute ischemic stroke who were treated with IV rt-PA within 4.5 hours of symptom onset from February 2009 to December 2016 were included in the study at the stroke center of Eskişehir Osmangazi University Medical Faculty. ENI was defined as an improvement in National Institutes of Health Stroke Scale (NIHSS) score of ≥8 points compared to the pretreatment score or an NIHSS score of 0 or 1 at 24 hours after stroke. We assessed the outcomes at 3 months after treatment using the modified Rankin Scale (mRS) score, and mRS scores of 0–1 were defined as ‘very good’ outcomes. Results: ENI was observed in 43.9% of 355 patients included in the study. Very good outcome at the 3rd month was detected in 80.1% of the patients with ENI, and in 15.6% of the patients without ENI (p<0.001). Patients with ENI were younger (p=0.025), and had lower NIHSS scores (p=0.027) and higher ASPECT scores (p=0.008) than those without. The ENI group had lower serum glucose levels at the time of admission (p< 0.001). Additionally, the presence of diabetes mellitus, hypertension, and hyperdense artery sign were more frequent in the ENI group (p=0.001, p=0.024, and p<0.001, respectively). Finally, multiple regression analysis showed a significant relationship between serum glucose level, hyperdense artery sign, and ENI. Conclusion: There is a significant relationship between ENI and very good outcome at 3 months in acute stroke patients who received IV rtPA. Therefore, the management of factors such as serum glucose level, NIHSS score, ASPECT score and presence of hyperdense artery sign which are related to ENI, and the determination of treatment strategies according to them are important issues for achieving a better outcome in acute ischemic stroke.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | sezer eryıldız e, ÖZDEMİR A (2018). Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. , 80 - 83. 10.29399/npa.22664 |
| Chicago | sezer eryıldız ezgi,ÖZDEMİR Atilla Özcan Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. (2018): 80 - 83. 10.29399/npa.22664 |
| MLA | sezer eryıldız ezgi,ÖZDEMİR Atilla Özcan Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. , 2018, ss.80 - 83. 10.29399/npa.22664 |
| AMA | sezer eryıldız e,ÖZDEMİR A Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. . 2018; 80 - 83. 10.29399/npa.22664 |
| Vancouver | sezer eryıldız e,ÖZDEMİR A Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. . 2018; 80 - 83. 10.29399/npa.22664 |
| IEEE | sezer eryıldız e,ÖZDEMİR A "Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler." , ss.80 - 83, 2018. 10.29399/npa.22664 |
| ISNAD | sezer eryıldız, ezgi - ÖZDEMİR, Atilla Özcan. "Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler". (2018), 80-83. https://doi.org/10.29399/npa.22664 |
| APA | sezer eryıldız e, ÖZDEMİR A (2018). Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. Nöropsikiyatri Arşivi, 55(1), 80 - 83. 10.29399/npa.22664 |
| Chicago | sezer eryıldız ezgi,ÖZDEMİR Atilla Özcan Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. Nöropsikiyatri Arşivi 55, no.1 (2018): 80 - 83. 10.29399/npa.22664 |
| MLA | sezer eryıldız ezgi,ÖZDEMİR Atilla Özcan Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. Nöropsikiyatri Arşivi, vol.55, no.1, 2018, ss.80 - 83. 10.29399/npa.22664 |
| AMA | sezer eryıldız e,ÖZDEMİR A Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. Nöropsikiyatri Arşivi. 2018; 55(1): 80 - 83. 10.29399/npa.22664 |
| Vancouver | sezer eryıldız e,ÖZDEMİR A Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler. Nöropsikiyatri Arşivi. 2018; 55(1): 80 - 83. 10.29399/npa.22664 |
| IEEE | sezer eryıldız e,ÖZDEMİR A "Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler." Nöropsikiyatri Arşivi, 55, ss.80 - 83, 2018. 10.29399/npa.22664 |
| ISNAD | sezer eryıldız, ezgi - ÖZDEMİR, Atilla Özcan. "Akut İskemik İnmede İntravenöz Trombolitik Tedavi Sonrası Erken Dönem Tam İyileşme ile İlişkili Faktörler". Nöropsikiyatri Arşivi 55/1 (2018), 80-83. https://doi.org/10.29399/npa.22664 |
