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【medical-news】新方法可预测溶栓效果
NEW YORK (Reuters Health) Dec 12 - Thrombi that consist primarily of platelets are resistant to thrombolytic therapy, while thrombi that are erythrocyte-rich are likely to dissolve with thrombolysis, Korean investigators report. The Hounsfield Unit (HU) is a method by which the platelet composition can be analyzed.
An investigation into why some thrombi respond to thrombolysis and many do not was conducted by Dr. Eung Y. Kim and colleagues at Yonsei University Hospital in Seoul.
Dr. Kim's team studied 51 patients with acute anterior or middle cerebral artery territory ischemic stroke within 6 hours of symptom onset. Patients presenting within 3 hours received tPA. Those who did not respond to tPA were then treated with intra-arterial urokinase. Patients who presented within 3 to 6 hours of symptom onset received intra-arterial urokinase.
All patients underwent noncontrast CT and CT angiography. Using polyethylene tubes to simulate the intracranial arteries, the HU count was measured on noncontrast CT, from which the amount of erythrocytes and platelets within the thrombus was determined.
The HU count showed a linear correlation of the hemoglobin content of the thrombi. The lower the HU, the more platelet-rich was the thrombus composition. Cellular debris, found in older thrombi, also lowers the HU count.
Thrombi causing the acute cerebral infarction were detected on noncontrast CT in 40 of the 51 patients and 34 of the 40 received thrombolytic therapy. In the remaining 11 patients, in whom noncontrast CT was negative for thrombi, were found to have infarcts in the basal ganglia or cortex several days later.
Patients with lower HU counts, signifying platelet-rich thrombi, were resistant to thrombolysis, the investigators report in the November issue of Neurology. Size of the thrombus did not affect lysability in this study, Dr. Kim's group reports.
Subgroups were not analyzed in this study, and the "considerable overlap between HU values and TICI (thrombolysis in cerebral infarct) grades may limit the clinical usefulness of the measure," the investigators caution.
Neurology 2006;67:1846-1848.
http://www.medscape.com/viewarticle/549230 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Efficacy of Thrombolytic Therapy Predictable
新方法可预测溶栓效果
NEW YORK (Reuters Health) Dec 12 - Thrombi that consist primarily of platelets are resistant to thrombolytic therapy, while thrombi that are erythrocyte-rich are likely to dissolve with thrombolysis, Korean investigators report. The Hounsfield Unit (HU) is a method by which the platelet composition can be analyzed.
12月12日纽约，路透社健康消息：韩国研究者报道用HU法（Hounsfield Unit）可以检测血栓中血小板所占的比例，如果血栓主要是由血小板构成，则溶栓治疗效果差；反之，如果血栓主要由红细胞组成，则溶栓效果较好。
An investigation into why some thrombi respond to thrombolysis and many do not was conducted by Dr. Eung Y. Kim and colleagues at Yonsei University Hospital in Seoul.
这项研究由汉城的延世大学医院的Eung Y. Kim（金永毅）博士及同事完成。
Dr. Kim's team studied 51 patients with acute anterior or middle cerebral artery territory ischemic stroke within 6 hours of symptom onset. Patients presenting within 3 hours received tPA. Those who did not respond to tPA were then treated with intra-arterial urokinase. Patients who presented within 3 to 6 hours of symptom onset received intra-arterial urokinase.
金博士的研究组研究了51例发病6小时内的大脑前动脉或中动脉急性缺血性中风患者。发病3小时内的患者接受组织纤溶酶的治疗。无效的患者予尿激酶血管内溶栓。起病3至6小时之间的患者直接进行血管内溶栓治疗。
All patients underwent noncontrast CT and CT angiography. Using polyethylene tubes to simulate the intracranial arteries, the HU count was measured on noncontrast CT, from which the amount of erythrocytes and platelets within the thrombus was determined.
所有患者都进行增强CT及CT血管造影检查。使用聚乙烯管模拟颅内动脉，用增强CT测定其HU值，可以判断血栓内的红细胞及血小板的数量。
The HU count showed a linear correlation of the hemoglobin content of the thrombi. The lower the HU, the more platelet-rich was the thrombus composition. Cellular debris, found in older thrombi, also lowers the HU count.
HU值与血栓中的血红蛋白含量呈线性相关关系。HU值越低，血栓中含的血小板越多。陈旧性血栓中的细胞残骸也能降低HU值。
Thrombi causing the acute cerebral infarction were detected on noncontrast CT in 40 of the 51 patients and 34 of the 40 received thrombolytic therapy. In the remaining 11 patients, in whom noncontrast CT was negative for thrombi, were found to have infarcts in the basal ganglia or cortex several days later.
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作者:admin@医学,生命科学 2011-03-15 17:11
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