지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Objective : Leukoaraiosis (LA) has been suggested to be related to the poor outcome or the occurrence of symptomatic intracerebral hemorrhage (sICH) after acute ischemic stroke. We retrospectively investigated the influences of LA on long-term outcome and the occurrence of sICH after thrombolysis in acute ischemic stroke (AIS). Methods : In this study, we recruited 164 patients with AIS and magnetic resonance image (MRI)-detected thrombolysis. The presence and extent of LA were assessed using the Fazekas grading system. The National Institutes of Health Stroke Scale score was used to assess the baseline measure of neurologic severity, and the modified Rankin Scale score assessment was used up to 1 year after thrombolysis. Results : Of 164 subjects, 56 (34.2%) showed LA on MRI. Compared to the 108 patients without LA, the patients with LA were of much older age (p<0.01), had a higher prevalence of hypertension (p<0.01), and had a much poorer outcome at 90 days (p=0.05) and 1 yr (p=0.01) after thrombolysis. There were no significant differences in sICH between patients with and without LA on MRI. In univariate analysis for the occurrence of poor outcome at 90 days after thrombolysis, the size of ischemic lesion on diffusion weighted images (DWI), [odds ratio (OR), 1.03; 95% confidence interval (95% CI), 1.01-1.04; p<0.01], recanalization (OR, 0.03; 95% CI, 0.01-0.10; p<0.01), sICH (OR, 12.2; 95% CI, 1.54-95.8), neurologic severity (OR, 1.17; 95% CI, 1.09-1.25; p<0.01), blood glucose level (OR, 1.01; 95% CI, 1.00-1.02; p=0.03), and the presence of LA on MRI (OR, 2.01; 95% CI, 1.04-3.01; p=0.04) were statistically significant. In multivariate analysis, neurologic severity (OR, 1.14; 95% CI, 1.04-1.24; p<0.01), recanalization (OR, 0.03; 95% CI, 0.01-0.11; p<0.01), lesion size on DWI (OR, 1.02; 95% CI, 1.01-1.03; p=0.02), serum glucose level (OR, 1.01; 95% CI; 1.01-1.02; p=0.03), and the presence of LA on MRI (OR, 3.2; 95% CI, 1.22-8.48; p<0.01) showed statistically significant differences. These trends persisted up to 1 yr after thrombolysis. Conclusion : In this study, we demonstrated that the presence of LA on MRI might be related to poor outcome after use of intravenous tissue plasminogen activator in AIS.
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참고문헌 (30)
참고문헌 신청
Ariës MJ / 2010 / tPA treatment for acute ischaemic stroke in patients with leukoaraiosis / Eur J Neurol 17:866~870
Arsava EM / 2009 / Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke / Neurology 72:1403~1410
de Leeuw FE / 2001 / Prevalence of cerebral white matter lesions in elderly people : a population based magnetic resonance imaging study. The Rotterdam Scan Study / J Neurol Neurosurg Psychiatry 70:9~14
del Zoppo GJ / 1998 / PROACT : a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism / Stroke 29:4~11
del Zoppo GJ / 1998 / Ischaemic damage of brain microvessels : inherent risks for thrombolytic treatment in stroke / J Neurol Neurosurg Psychiatry 65:1~9
Arsava EM / 2009 / Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke / Neurology 72:1403~1410
de Leeuw FE / 2001 / Prevalence of cerebral white matter lesions in elderly people : a population based magnetic resonance imaging study. The Rotterdam Scan Study / J Neurol Neurosurg Psychiatry 70:9~14
del Zoppo GJ / 1998 / PROACT : a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism / Stroke 29:4~11
del Zoppo GJ / 1998 / Ischaemic damage of brain microvessels : inherent risks for thrombolytic treatment in stroke / J Neurol Neurosurg Psychiatry 65:1~9
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