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1、ThenewenglandjournalofmedicineoriginalarticleARandomizedTrialofTenecteplaseversusAlteplaseforAcuteIschemicStrokeMarkParsons,M.D.,NeilSpratt,M.D.,AndrewBivard,B.Sc.,BruceCampbell,M.D.,KongChung,M.D.,FerdinandMiteff,M.D.,BillO’Brien,M.D.,ChristopherBladin,M.D.,PatrickMcElduff,Ph.D.,
2、ChrisAllen,M.D.,GrantBateman,M.D.,GeoffreyDonnan,M.D.,StephenDavis,M.D.,andChristopherLevi,M.D.ABSTRACTBACKGROUNDIntravenousalteplaseistheonlyapprovedtreatmentforacuteischemicstroke.TenecFromtheDepartmentsofNeurologyteplase,ageneticallyengineeredmutanttissueplasminogenactivator,is
3、analterna(M.P.,N.S.,A.B.,K.C.,F.M.,B.O.,C.L.),ClinicalResearchDesign,Informationtivethrombolyticagent.Technology,andStatisticalSupport(P.M.),andRadiology(C.A.,G.B.),JohnMETHODSHunterHospital–HunterMedicalRe-searchInstitute,UniversityofNewcastle,Inthisphase2Btrial,werandomlyassigne
4、d75patientstoreceivealteplase(0.9mgperNewcastle,NSW;theDepartmentofkilogramofbodyweight)ortenecteplase(0.1mgperkilogramor0.25mgperkiloNeurology,RoyalMelbourneHospitalgram)lessthan6hoursaftertheonsetofischemicstroke.Tofavortheselectionof(B.C.,S.D.),andFloreyNeuroscienceIn-stitutes(
5、G.D.),UniversityofMelbourne,patientsmostlikelytobenefitfromthrombolytictherapy,theeligibilitycriteriawereMelbourne,VIC;andtheDepartmentofaperfusionlesionatleast20%greaterthantheinfarctcoreoncomputedtomographicNeurosciences,BoxHillHospital–Eastern(CT)perfusionimagingatbaselineandan
6、associatedvesselocclusiononCTangiogHealth,MonashUniversity(C.B.),Mel-bourne,VIC—allinAustralia.Addressraphy.ThecoprimaryendpointsweretheproportionoftheperfusionlesionthatwasreprintrequeststoDr.ParsonsattheDe-reperfusedat24hoursonperfusionweightedmagneticresonanceimagingandthepartm
7、entofNeurology,JohnHunterHos-extentofclinicalimprovementat24hoursasassessedontheNationalInstitutesofpital,LockedBagNo.1,HunterRegionMailCentre,Newcastle,NSW2310,Aus-HealthStrokeScale(NIHSS,a42pointscaleonwhichhigherscoresindicatemoretralia,oratmark.parsons@hnehealth.nswsevereneuro
8、logicdeficits)..gov.au.NEnglJMed2
