县级医院急性缺血性卒中血管再通治疗院内流程的调查研究

注册号:

Registration number:

ChiCTR2500108454 

最近更新日期:

Date of Last Refreshed on:

2025-09-01 08:46:28 

注册时间:

Date of Registration:

2025-09-01 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

县级医院急性缺血性卒中血管再通治疗院内流程的调查研究

Public title:

Investigation on the workflow of intrahospital reperfusion therapy for acute ischemic stroke in county-level hospitals

注册题目简写:

WIRIS研究

English Acronym:

WIRIS Trial

研究课题的正式科学名称:

二级医院急性缺血性卒中院内再通治疗流程优化的建立与实践

Scientific title:

Establishment and practice of an optimized intrahospital reperfusion therapy for acute ischemic stroke in secondary hospitals

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

张振昶 

研究负责人:

张振昶 

Applicant:

Zhang Zhenchang 

Study leader:

Zhang Zhenchang 

申请注册联系人电话:

Applicant telephone:

+86 138 9364 7595

研究负责人电话:

Study leader's
telephone:

+86 138 9364 7595

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

13893647595@163.com

研究负责人电子邮件:

Study leader's E-mail:

13893647595@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

甘肃省兰州市城关区萃英门82号

研究负责人通讯地址:

甘肃省兰州市城关区萃英门82号

Applicant address:

82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China

Study leader's address:

82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

兰州大学第二医院(第二临床医学院)

Applicant's institution:

The Second Hospital & Clinical Medical School, Lanzhou University

研究负责人所在单位:

兰州大学第二医院(第二临床医学院)

Affiliation of the Leader:

The Second Hospital & Clinical Medical School, Lanzhou University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025A-683

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

兰州大学第二医院(第二临床医学院)医学伦理委员会

Name of the ethic committee:

The Second Affiliated Hospital of the Second Hospital & Clinical Medical School, Lanzhou University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-07-03 00:00:00

伦理委员会联系人:

郑亚君

Contact Name of the ethic committee:

Zheng Yajun

伦理委员会联系地址:

甘肃省兰州市城关区萃英门82号

Contact Address of the ethic committee:

82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 136 5932 6689

伦理委员会联系人邮箱:

Contact email of the ethic committee:

13659326689@163.com

研究实施负责(组长)单位:

兰州大学第二医院(第二临床医学院)

Primary sponsor:

The Second Hospital & Clinical Medical School, Lanzhou University

研究实施负责(组长)单位地址:

甘肃省兰州市城关区萃英门82号

Primary sponsor's address:

82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

甘肃

市(区县):

兰州

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

兰州大学第二医院(第二临床医学院)

具体地址:

甘肃省兰州市城关区萃英门82号

Institution
hospital:

The Second Hospital & Clinical Medical School, Lanzhou University

Address:

82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, China

经费或物资来源:

癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项

Source(s) of funding:

Noncommunicable Chronic Diseases-National Science and Technology Major Project

研究疾病:

急性缺血性卒中  

Target disease:

Acute ischemic stroke

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

横断面 

Study design:

Cross-sectional 

研究目的:

分析以甘肃省为主的县级医院AIS院内再通治疗延误的影响因素,为优化县级医院AIS院内再通治疗流程提供真实依据。  

Objectives of Study:

The aim is to analyze the factors affecting the delay of acute ischemic stroke (AIS) intrahospital reperfusion therapy in county-level hospitals (mainly in Gansu Province), and provide a real basis for optimizing the process of AIS intrahospital reperfusion therapy in county-level hospitals.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 经头颅CT或MRI证实颅内出血(包括脑实质出血、脑室内出血、蛛网膜下腔出血、硬膜下/外血肿等); 2. 既往颅内出血史; 3. 近3个月内有严重头外伤或卒中史; 4. 颅内肿瘤、巨大颅内动脉瘤; 5. 近期(3个月)有颅内或椎管内手术; 6. 近2周内大型外科手术; 7. 近3周内有胃肠或泌尿系统出血; 8. 活动性内脏出血; 9. 主动脉弓夹层; 10. 近1周内有在不易压迫止血部位的动脉穿刺; 11. 血压升高:收缩压>180 mmHg或舒张压>100 mmHg,并药物难以控制; 12. 急性出血倾向,包括血小板计数<100×109或其他情况; 13. 24h内接受过低分子肝素治疗; 14. 口服抗凝剂(华法林)且INR>1.7或PT>15 s; 15. 48 h内使用凝血酶抑制剂或Xa因子抑制剂,或各种实验室检查异常(如 APTT、INR、血小板计数、ECT、TT或Xa因子活性测定等); 16. 血糖<2.8或>22.22 mmol/L,并难以纠正; 17. 头颅CT或MRI提示大面积梗死(梗死面积>1/3大脑中动脉供血区); 18. 孕产妇; 19. 院内卒中; 20. 诊断检查不确定或显示卒中以外的可能原因的事件。

Exclusion criteria:

1. Intracranial hemorrhage confirmed by cranial computed tomography (CT) or magnetic resonance imaging (MRI), including cerebral parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural/extradural hematoma, etc; 2. History of prior intracranial hemorrhage; 3. Severe head trauma or stroke within the past 3 months; 4. Intracranial tumor, giant intracranial aneurysm; 5. Intracranial or intraspinal surgery within 3 months; 6. Major surgical procedures within the past 2 weeks; 7. Gastrointestinal or genitourinary bleeding within the past 3 weeks; 8. Active visceral bleeding; 9. Aortic arch dissection; 10. Arterial puncture at a non-compressible site within the previous week; 11. Elevated blood pressure: systolic pressure >180 mmHg or diastolic pressure >100 mmHg, and difficult to control with medication; 12. Acute bleeding tendency, including platelet count <100×10⁹/L or other conditions; 13. Treatment with low molecular weight heparin within 24 hours; 14. Use of oral anticoagulants (e.g., warfarin) with INR >1.7 or PT >15 s; 15. Use of thrombin inhibitors or Xa factor inhibitors within 48 hours, or abnormal laboratory tests (such as APTT, INR, platelet count, ECT, TT, or Xa factor activity assay, etc.); 16. Blood glucose level <2.8 mmol/L or >22.22 mmol/L, and difficult to correct; 17.Head CT or MRI indicates a large area of infarction (infarction area>1/3 of the middle cerebral artery supply area); 18. Pregnancy or postpartum status; 19. In-hospital stroke; 20. Diagnostic workup is uncertain or suggests an event other than stroke as the likely cause.

研究实施时间:

Study execute time:

From 2025-09-01 00:00:00 To 2026-08-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-09-01 00:00:00 To 2026-08-31 00:00:00

干预措施:

Interventions:

组别:

静脉溶栓

样本量:

539

Group:

Intravenous thrombolysis

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

兰州市第一人民医院城管医院 

单位级别:

二级 

Institution
hospital:

Chengguan Hospital of Lanzhou First People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

西固区人民医院 

单位级别:

二级 

Institution
hospital:

Xigu People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

兰州新区第一人民医院 

单位级别:

二级 

Institution
hospital:

The First People's Hospital of Lanzhou New Area

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

榆中县第一人民医院 

单位级别:

三级乙等 

Institution
hospital:

The First People's Hospital of Yuzhong County

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

皋兰县人民医院 

单位级别:

二级 

Institution
hospital:

Gaolan County People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

陇南 

Country:

China

Province:

Gansu

City:

Longnan

单位(医院):

礼县第一人民医院 

单位级别:

二级 

Institution
hospital:

The First People's Hospital of Lixian County

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

天水 

Country:

China

Province:

Gansu

City:

Tianshui

单位(医院):

秦安县人民医院 

单位级别:

二级 

Institution
hospital:

Qin'an County People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

定西 

Country:

China

Province:

Gansu

City:

Dingxi

单位(医院):

岷县人民医院 

单位级别:

二级 

Institution
hospital:

Minxian County People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

定西 

Country:

China

Province:

Gansu

City:

Dingxi

单位(医院):

岷县中医院 

单位级别:

二级 

Institution
hospital:

Minxian County Hospital of Traditional Chinese Medicine

Level of the institution:

Secondary

国家:

中国

省(直辖市):

甘肃 

市(区县):

定西 

Country:

China

Province:

Gansu

City:

Dingxi

单位(医院):

陇西县第一人民医院 

单位级别:

三级乙等 

Institution
hospital:

The First People's Hospital of Longxi County

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

甘肃 

市(区县):

平凉 

Country:

China

Province:

Gansu

City:

Pingliang

单位(医院):

静宁县人民医院 

单位级别:

三级乙等 

Institution
hospital:

Jingning County People's Hospital

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

甘肃 

市(区县):

庆阳 

Country:

China

Province:

Gansu

City:

Qingyang

单位(医院):

西峰区人民医院 

单位级别:

二级 

Institution
hospital:

Xifeng District People's Hospital

Level of the institution:

Secondary

测量指标:

Outcomes:

指标中文名:

急性缺血性卒中患者入院到静脉溶栓药物使用的时间(DNT)

指标类型:

主要指标

Outcome:

door to needletime (DNT)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

DNT≤60分钟的比例(%)

指标类型:

次要指标

Outcome:

Proportion of Cases with DNT <=60 Minutes (%)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

从发病到静脉溶栓药物使用的时间(ONT)

指标类型:

次要指标

Outcome:

door to needletime, DNT

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

90天mRS评分

指标类型:

次要指标

Outcome:

MRS (Modified Rankin Scale) score at 90 days

Type:

Secondary indicator

测量时间点:

90天

测量方法:

Measure time point of outcome:

Day 90

Measure method:

指标中文名:

7天内症状性颅内出血发生率及90天死亡率。

指标类型:

主要指标

Outcome:

Incidence of Symptomatic Intracranial Hemorrhage within 7 Days and 90-Day Mortality Rate

Type:

Primary indicator

测量时间点:

7天,90天

测量方法:

Measure time point of outcome:

Day 7 and 90

Measure method:

指标中文名:

7天内无症状性颅内出血(aSICH)发生率

指标类型:

次要指标

Outcome:

Incidence of asymptomatic intracranial hemorrhage (aSICH) within 7 days

Type:

Secondary indicator

测量时间点:

7天

测量方法:

Measure time point of outcome:

Day 7

Measure method:

指标中文名:

非颅内出血并发症发生率(包括胃肠道出血、尿道出血、口腔或鼻粘膜出血及皮下血肿等)

指标类型:

次要指标

Outcome:

Incidence of non-intracranial hemorrhagic complications (including gastrointestinal bleeding, urinary tract bleeding, oral or nasal mucosal bleeding, subcutaneous hematoma, etc.)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非出血性严重不良事件发生率(包括脑疝、肺炎、呼吸衰竭、循环衰竭、应激性溃疡、继发性癫痫、泌尿道感染、败血症、肾功能衰竭、急性冠脉综合征、静脉血栓形成及精神症状等)

指标类型:

次要指标

Outcome:

Incidence of non-hemorrhagic serious adverse events (including cerebral herniation, pneumonia, respiratory failure, circulatory failure, stress ulcer, secondary epilepsy, urinary tract infection, sepsis, renal failure, acute coronary syndrome, venous thrombosis, and psychiatric symptoms, etc.)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

None

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

相关论文发表5年后在Resman平台公开原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Related papers published five years later, the IPD will be shared on ResMan.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

采用病例报告表(CRF).

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Use Case Record Form (CRF).

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-09-01 08:46:03