3 CNSR 中国卒中登记研究.pdf

Using Recombinant Tissue Plasminogen Activator to Treat Acute Ischemic Stroke in China Analysis of the Results From the Chinese National Stroke Registry (CNSR) Yilong Wang, MD; Xiaoling Liao, MD; Xingquan Zhao, MD; David Z. Wang, DO; Chunxue Wang, MD; Mai N. Nguyen-Huynh, MD, MAS; Yong Zhou, MD; Liping Liu, MD; Xianwei Wang, MD; Gaifen Liu, PhD; Hao Li, PhD; Yongjun Wang, MD; on behalf of the China National Stroke Registry (CNSR) Investigators Background and Purpose—Little is known about intravenous recombinant tissue plasminogen activator (rtPA) use in China. By accessing the Chinese National Stroke Registry (CNSR), the rate of intravenous rtPA use was reviewed. We specifically examined the issues of prehospital and in-emergency department delay and compared them with the published data from developed countries. Methods—Funded by Chinese government, CNSR is the only nationwide stroke registry that includes 132 urban hospitals. All patients eligible for intravenous rtPA were included for analysis. We then compared the onset-to-needle time and door-to-needle time in the emergency department in China with those in developed countries. Results—From September 2007 to August 2008, 14 702 patients with ischemic stroke were entered into CNSR. Among 11 675 patients with known time of stroke onset, 2514 (21.5%) presented to the emergency department within 3 hours, 1469 (12.6%) were eligible for thrombolytic treatment, and 284 (2.4%) were finally treated, 181 (1.6%) of them with intravenous rtPA. The median onset-to-needle time was 180 (interquartile range, 150 to 228) minutes; the median door-to-needle time was 116 (interquartile range, 70 to 150) minutes; the median imaging-to-n