innosferaНаука и инновацииScience and Innovations1818-98572412-9372Издательский дом «Белорусская наука»10.29235/1818-9857-2022-3-77-83innosfera-56Research ArticleДИССЕРТАЦИОННЫЕ ИССЛЕДОВАНИЯDISSERTATION RESEARCHПредикторы трехмесячного функционального исхода системной тромболитической терапии при инфаркте головного мозгаThree-month functional outcome predictors of systemic thrombolytic therapy in cerebral infarctionСенькоК.SenkoK.

Кирилл Сенько, врач кабинета КТ Городской клинической больницы скорой медицинской помощи г. Минска; соискатель кафедры нервных и нейрохирургических болезней Белорусского государственного медицинского университета

Kirill Senko

ckb88@mail.ruФедуловА.FedulovA.

Александр Федулов, заведующий кафедрой нервных и нейрохирургических болезней, доктор медицинских наук, профессор

Alexander Fedulov

fedulov@tut.byГородская клиническая больница скорой медицинской помощи г. Минска; Белорусский государственный медицинский университетBelarusБелорусский государственный медицинский университетBelarus202229042022037783Copyright © Издательский дом «Белорусская наука», 20222022Издательский дом «Белорусская наука»Издательский дом «Белорусская наука»https://innosfera.belnauka.by/jour/about/submissions#copyrightNoticehttps://innosfera.belnauka.by/jour/article/view/56

Приводится анализ клинико лабораторных и нейрорадиологических предикторов трехмесячного функционального исхода системной тромболитической терапии (сТЛТ) у пациентов с инфарктом головного мозга (ИМ). Выявление факторов, ассоциированных с неблагоприятным исходом системного тромболизиса, может способствовать более безопасному, эффективному и широкому применению данного метода лечения.

The article analyzes the clinical, laboratory and neuroimaging predictors of a three-month functional outcome of systemic thrombolytic therapy in patients with cerebral infarction is presented. Recently, techniques for the diagnosis and treatment of cerebral infarction have been actively developed, which has led to a decrease in mortality and a significant improvement in the functional outcome in some patients. The therapeutic response to ongoing therapy cannot be accurately predicted prior to its initiation, which makes it difficult to make the right decision regarding treatment tactics. The main focus is on the search and evaluation of the degree of determination in the outcome of thrombolytic therapy of the most significant predictors, as well as their mutual potentiation. Identification of factors associated with an unfavorable outcome of systemic thrombolysis can contribute to a safer, more effective and more widespread use of this treatment method in the shortest possible time.

инфаркт мозгатромболизиспрогнозированиепредикторыcerebral infarctionthrombolysispredictionpredictorsReferencesStroke Council of the American Cardiac Association. Advice for healthcare providers from the American Heart Association / American Stroke Association / V. J. Powers [et al.] // Stroke. 2018. Vol. 49. P. 46–110.Stroke Council of the American Cardiac Association. Advice for healthcare providers from the American Heart Association / American Stroke Association / V. J. Powers [et al.] // Stroke. 2018. Vol. 49. P. 46–110.HERMES employees. Endovascular thrombectomy after ischemic stroke in large vessels: a meta-analysis of individual patient data from five randomized trials / M. Goyal [et al.] // Lancet. 2016. Vol. 387. P. 1723–1731.HERMES employees. Endovascular thrombectomy after ischemic stroke in large vessels: a meta-analysis of individual patient data from five randomized trials / M. Goyal [et al.] // Lancet. 2016. Vol. 387. P. 1723–1731.Домашенко М. А. Системный тромболизис при ишемическом инсульте: клинические факторы персонифицированной эффективности и безопасности / М. А. Домашенко, М. Ю. Максимова, М. М. Танашян // Анналы клинической и экспериментальной неврологии. 2019. Т. 13. №1. С. 5–14.Домашенко М. А. Системный тромболизис при ишемическом инсульте: клинические факторы персонифицированной эффективности и безопасности / М. А. Домашенко, М. Ю. Максимова, М. М. Танашян // Анналы клинической и экспериментальной неврологии. 2019. Т. 13. №1. С. 5–14.Персонификация подходов к реперфузионной терапии ишемического инсульта / М. А. Домашенко [и др.] // Анналы клинической и экспериментальной неврологии. 2017. Т. 11. №1. С. 7–13.Персонификация подходов к реперфузионной терапии ишемического инсульта / М. А. Домашенко [и др.] // Анналы клинической и экспериментальной неврологии. 2017. Т. 11. №1. С. 7–13.National institutes of health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke / M. R. Heldner [et al.] // Stroke. 2013. Vol. 44. P. 1153–1157.National institutes of health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke / M. R. Heldner [et al.] // Stroke. 2013. Vol. 44. P. 1153–1157.Teasdale G. M. Assessment of coma and impaired consciousness: A practical scale / G. M. Teasdale, B. Jennett // Lancet. 1974. Vol. 2. №7872. P. 81–84.Teasdale G. M. Assessment of coma and impaired consciousness: A practical scale / G. M. Teasdale, B. Jennett // Lancet. 1974. Vol. 2. №7872. P. 81–84.Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS study group. Alberta stroke programme early CT score / P. A. Barber [et al.] // Lancet. 2000. Vol. 355. P. 1670–1674.Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS study group. Alberta stroke programme early CT score / P. A. Barber [et al.] // Lancet. 2000. Vol. 355. P. 1670–1674.MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging / F. Fazekas [et al.] // A. J. Roentgen. 1987. Vol. 149. №2. P. 351–356.MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging / F. Fazekas [et al.] // A. J. Roentgen. 1987. Vol. 149. №2. P. 351–356.Inter- and intraobserver reproducibility of cerebral atrophy assessment on MRI scans with hemispheric infarcts / F. Pasquier [et al.] // Eur. Neurol. 1997. Vol. 36. №5. P. 268–272.Inter- and intraobserver reproducibility of cerebral atrophy assessment on MRI scans with hemispheric infarcts / F. Pasquier [et al.] // Eur. Neurol. 1997. Vol. 36. №5. P. 268–272.Hemorrhagic transformation within 36 hours of a cerebral infarct. Relationship with early clinical deterioration and 3-month outcome in the ECASS I cohort / M. Fiorelly [et al.] // Stroke. 1999. Vol. 30. P. 2280–2284.Hemorrhagic transformation within 36 hours of a cerebral infarct. Relationship with early clinical deterioration and 3-month outcome in the ECASS I cohort / M. Fiorelly [et al.] // Stroke. 1999. Vol. 30. P. 2280–2284.Системный тромболизис при ишемическом инсульте / С. Д. Кулеш [и др.] // Здравоохранение. 2011. Т. 12. C. 55–77.Системный тромболизис при ишемическом инсульте / С. Д. Кулеш [и др.] // Здравоохранение. 2011. Т. 12. C. 55–77.W. J. Bonfire. Creating the best fit: choosing indicators for clinical trial results and research results / W. J. Bonfire // Am. J. Occup. Ther. 2013. Vol. 67. P. 162–170.W. J. Bonfire. Creating the best fit: choosing indicators for clinical trial results and research results / W. J. Bonfire // Am. J. Occup. Ther. 2013. Vol. 67. P. 162–170.Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials / J. Emberson [et al.] // Lancet. 2014. Vol. 384. P. 1929–1935.Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials / J. Emberson [et al.] // Lancet. 2014. Vol. 384. P. 1929–1935.Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis / J. M. Wardlaw [et al.] // Lancet. 2012. Vol. 379. P. 2364–2372.Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis / J. M. Wardlaw [et al.] // Lancet. 2012. Vol. 379. P. 2364–2372.Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials / J. Emberson [et al.] // Lancet. 2014. Vol. 384. P. 1929–1935.Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials / J. Emberson [et al.] // Lancet. 2014. Vol. 384. P. 1929–1935.NIHSS-time score easily predicts outcomes in rt-PA patients: The SAMURAI rt-PA registry / J. Aoki [et al.] // J. Neurol. Sci. 2013. Vol. 327. P. 6–11.NIHSS-time score easily predicts outcomes in rt-PA patients: The SAMURAI rt-PA registry / J. Aoki [et al.] // J. Neurol. Sci. 2013. Vol. 327. P. 6–11.A simple risk index and thrombolytic treatment response in acute ischemic stroke / B. Obviagele [et al.] // JAMA Neurol. 2014. Vol. 71. P. 848–854.A simple risk index and thrombolytic treatment response in acute ischemic stroke / B. Obviagele [et al.] // JAMA Neurol. 2014. Vol. 71. P. 848–854.The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke // N. Engl. J. Med. 1995. Vol. 333. P. 1581–1587.The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke // N. Engl. J. Med. 1995. Vol. 333. P. 1581–1587.The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the Third International Stroke Trial [IST-3]): a randomised controlled trial / P. Sandercock [et al.] // Lancet. 2012. Vol. 379. P. 2352–2363.The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the Third International Stroke Trial [IST-3]): a randomised controlled trial / P. Sandercock [et al.] // Lancet. 2012. Vol. 379. P. 2352–2363.Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke / W. Hacke [et al.] // N. Engl. J. Med. 2008. Vol. 359. P. 1317–1322.Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke / W. Hacke [et al.] // N. Engl. J. Med. 2008. Vol. 359. P. 1317–1322.

The authors declare that there are no conflicts of interest present.