EFIKASNOST I BEZBEDNOST PRIMENE INTRAVENSKE TROMBOLIZE U LEČENJU AKUTNOG ISHEMIJSKOG MOŽDANOG UDARA KOD MLADIH ODRASLIH OSOBA
Sažetak
Uvod: Moždani udar kod mladih odraslih osoba ima veliki socioekonomski značaj, jer dovodi do smrtnog ishoda i trajnih sekvela kod ovih pacijenata u preko 30% slučajeva, a karakteriše ga i očekivano duže preživljavanje u poređenju sa starijim pacijentima.
Cilj rada: Utvrditi efikasnost i bezbednost intravenske primene trombolitičke terapije kod mladih odraslih pacijenata sa AIMU u poređenju sa starijim pacijentima.
Materijal i metode: Ispitano je 403 pacijenta lečenih od AIMU intravenskom trombolizom, koji su prema godinama starosti podeljeni u 2 grupe, pacijenti starosti 18 - 45 godina (n=59) i pacijenti stariji od 45 godina (n=344). Pored utvrđivanja mortaliteta, rađena je i procena funkcionalnog ishoda modifikovanom Rankin skalom (mRS), kao i prisustva i tipa sICH. Pacijenti su praćeni 3 meseca nakon primene terapije.
Rezultati: Nije pokazana statistički značajna razlika u odličnom (mRS ≤ 1) (p = 0,149) i dobrom funcionalnom ishodu (mRS ≤ 2) (p = 0,156) između ove 2 grupe pacijenata, dok je procenat smrtnog ishoda bio značajno manji u grupi mlađih pacijenata (≤ 45 god. 5,2% vs. > 45 god. 17,3%, p = 0,019). Takođe, nije pokazana statistički značajna razlika u prisustvu i tipu sICH između ove 2 grupe pacijenata.
Zaključak: Ne postoji značajna razlika u dobrom i odličnom funkcionalnom ishodu, kao ni u incidenci simptomatske intracerebralne hemoragije (sICH) kod mladih odraslih pacijenata sa akutnim ishemijskim moždanim udarom (AIMU) nakon intravenske primene trombolize u odnosu na stariju grupu pacijenata. Zapažena je statistički značajna razlika u smrtnom ishodu koji je bio manji u grupi mlađih pacijenata.
Ključne reči: akutni moždani udar, mladi odrasli, ishod, intravenska tromboliza
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