优化替奈普酶剂量在发病4.5小时内非大、中血管闭塞缺血性卒中患者中的有效性和安全性:一项前瞻性、多中心、开放标签、平行、随机对照临床研究

注册号:

Registration number:

ChiCTR2600124514 

最近更新日期:

Date of Last Refreshed on:

2026-05-14 16:52:52 

注册时间:

Date of Registration:

2026-05-13 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

优化替奈普酶剂量在发病4.5小时内非大、中血管闭塞缺血性卒中患者中的有效性和安全性:一项前瞻性、多中心、开放标签、平行、随机对照临床研究

Public title:

Efficacy and safety of optimized tenecteplase dose in patients with ischemic stroke without large or medium vessel occlusion within 4.5 hours of onset: a prospective, multicenter, open-label, parallel, randomized controlled clinical trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

优化替奈普酶剂量在发病4.5小时内非大、中血管闭塞缺血性卒中患者中的有效性和安全性:一项前瞻性、多中心、开放标签、平行、随机对照临床研究

Scientific title:

Efficacy and safety of optimized tenecteplase dose in patients with ischemic stroke without large or medium vessel occlusion within 4.5 hours of onset: a prospective, multicenter, open-label, parallel, randomized controlled clinical trial

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:

曾国勇 

研究负责人:

曾国勇 

Applicant:

Zeng Guoyong 

Study leader:

Zeng Guoyong 

申请注册联系人电话:

Applicant telephone:

+86 797 588 9991

研究负责人电话:

Study leader's
telephone:

+86 797 588 9991

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:

hsyygy@126.com

研究负责人电子邮件:

Study leader's E-mail:

hsyygy@126.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:

江西省赣州市章贡区梅关大道16号

研究负责人通讯地址:

江西省赣州市章贡区梅关大道16号

Applicant address:

16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi Province, China

Study leader's address:

16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi 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:

赣州市人民医院

Applicant's institution:

Ganzhou People's Hospital

研究负责人所在单位:

赣州市人民医院

Affiliation of the Leader:

Ganzhou People's Hospital

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:

PJB2026-067-01

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:

赣州市人民医院临床科研伦理分委员会

Name of the ethic committee:

Research Ethics Sub-Committee of Ganzhou People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-10 00:00:00

伦理委员会联系人:

刘文群

Contact Name of the ethic committee:

Liu Wenqun

伦理委员会联系地址:

江西省赣州市章贡区梅关大道16号

Contact Address of the ethic committee:

16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 797 5889157

伦理委员会联系人邮箱:

Contact email of the ethic committee:

408488245@qq.com

研究实施负责(组长)单位:

赣州市人民医院

Primary sponsor:

Ganzhou People's Hospital

研究实施负责(组长)单位地址:

江西省赣州市章贡区梅关大道16号

Primary sponsor's address:

16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi 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):

江西省

市(区县):

Country:

China

Province:

Jiangxi

City:

单位(医院):

赣州市人民医院

具体地址:

江西省赣州市章贡区梅关大道16号

Institution
hospital:

Ganzhou People's Hospital

Address:

16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi Province, China

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self selected topic (self funded)

研究疾病:

缺血性卒中  

Target disease:

ischemic stroke

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

主要目的:比较0.225mg/kg剂量与0.25mg/kg剂量TNK在发病4.5h内非大血管闭塞缺血性卒中患者中90天改良Rankin评分(mRS评分)0-2分所占比例和48h症状性颅内出血发生率。 次要目的: (1)比较0.225mg/kg剂量与0.25mg/kg剂量TNK在发病4.5h内非大血管闭塞缺血性卒中患者中的早期神经功能改善比例; (2)比较0.225mg/kg剂量与0.25mg/kg剂量TNK在发病4.5h内非大血管闭塞缺血性卒中患者中非颅内部位出血比例; (3)比较0.225mg/kg剂量与0.25mg/kg剂量TNK在发病4.5h内非大血管闭塞缺血性卒中患者中90天死亡率; (4)比较0.225mg/kg剂量与0.25mg/kg剂量TNK在发病4.5h内非大血管闭塞缺血性卒中患者中不良事件的发生率。  

Objectives of Study:

Primary objective: To compare the incidence of modified Rankin score (mRS)0-2 at 90 days and symptomatic intracranial hemorrhage at 48 hours in patients with non-large vessel occlusion ischemic stroke within 4.5 hours of onset at 0.225mg/kg and 0.25mg/kg dose of TNK. Secondary objectives: (1) To compare the proportion of early neurological improvement between 0.225mg/kg dose and 0.25mg/kg dose of TNK in patients with ischemic stroke without large vessel occlusion within 4.5 hours of onset; (2) To compare the incidence of non-intracranial hemorrhage between 0.225mg/kg TNK and 0.25mg/kg TNK in patients with ischemic stroke without large vessel occlusion within 4.5 hours after onset; (3) To compare the 90-day mortality between 0.225mg/kg and 0.25mg/kg TNK in patients with ischemic stroke without large vessel occlusion within 4.5h of onset; (4) To compare the incidence of adverse events between 0.225mg/kg dose and 0.25mg/kg dose of TNK in patients with ischemic stroke without large vessel occlusion within 4.5 hours after onset.

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.明确责任血管为大血管闭塞,且需要行血管内治疗; 2.3个月内发生过颅内出血或全身系统性出血;或符合静脉溶栓的其他禁忌症; 3.严重肝/肾功能不全:入院ALT在正常值3倍以上/INR>1.2/肝性脑病/既往药物所致肝功能不全;肾小球滤过率<30 mL/min; 4.发病前mRS≥2; 5.终末期疾病(恶性肿瘤、终末期肾病等)预计生存时间<3个月; 6.孕妇/哺乳期; 7.影响随访时神经功能评估的其他神经系统疾病; 8.参加其他干预性临床研究。

Exclusion criteria:

1. It was clear that the offending vessel was large vessel occlusion and needed endovascular treatment; 2. Intracranial hemorrhage or systemic hemorrhage within 3 months; Other contraindications to intravenous thrombolysis; 3. Severe liver/renal dysfunction: ALT > 3 times normal value at admission /INR > 1.2/ hepatic encephalopathy/previous drug-induced liver dysfunction; Glomerular filtration rate <30 mL/min; 4. mRS >=2 before onset; 5. The predicted survival time of end-stage disease (malignant tumor, end-stage renal disease, etc.) was less than 3 months; 6. Pregnant/lactating period; 7. Other neurological diseases affecting the follow-up neurological function assessment; 8. Oarticipating in other interventional clinical studies.

研究实施时间:

Study execute time:

From 2025-12-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-09-01 00:00:00

干预措施:

Interventions:

组别:

实验组

样本量:

811

Group:

Experimental group

Sample size:

干预措施:

低剂量(0.225mg/kg)TNK治疗

干预措施代码:

Intervention:

Low dose (0.225mg/kg) of TNK was given

Intervention code:

组别:

标准治疗组

样本量:

811

Group:

Standard-care Group

Sample size:

干预措施:

标准剂量TNK治疗

干预措施代码:

Intervention:

Standard dose of TNK was administered

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江西省 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

赣州市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Ganzhou People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东省 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

南方医科大学南方医院 

单位级别:

三级甲等 

Institution
hospital:

Nanfang Hospital, Southern Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江西省 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

江西省上犹县人民医院 

单位级别:

三级医院 

Institution
hospital:

Shangyou County People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江西省 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

瑞金市人民医院 

单位级别:

三级医院 

Institution
hospital:

Ruijin City People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

湖南省 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

湘潭市中心医院 

单位级别:

三级甲等 

Institution
hospital:

Xiangtan Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北省 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

宜昌市夷陵医院 

单位级别:

三级医院 

Institution
hospital:

Yichang Yiling Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江西省 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

全南县人民医院 

单位级别:

二级甲等 

Institution
hospital:

Quannan County People's Hospital

Level of the institution:

Secondary A

国家:

中国

省(直辖市):

江西省 

市(区县):

 

Country:

China

Province:

Jiangxi

City:

单位(医院):

于都县人民医院 

单位级别:

三级医院 

Institution
hospital:

Yudou County People's Hospital

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

90天mRS 0-1分(%)

指标类型:

主要指标

Outcome:

proportion of patients with mRS score 0-1 at 90 days (%)

Type:

Primary indicator

测量时间点:

90天

测量方法:

Measure time point of outcome:

90 days

Measure method:

指标中文名:

90天EQ-5D-5L量表评分

指标类型:

次要指标

Outcome:

90-day EQ-5D-5L scale score

Type:

Secondary indicator

测量时间点:

随机后90天

测量方法:

Measure time point of outcome:

After randomization for 90 days

Measure method:

指标中文名:

90天mRS评分

指标类型:

次要指标

Outcome:

90-day mRS score

Type:

Secondary indicator

测量时间点:

随机后90天

测量方法:

mRS评分量表

Measure time point of outcome:

After randomization for 90 days

Measure method:

mRS scoring scale

指标中文名:

48h内症状性颅内出血(SICH)发生率

指标类型:

主要指标

Outcome:

The incidence of symptomatic intracranial hemorrhage (SICH) within 48 hours

Type:

Primary indicator

测量时间点:

48小时

测量方法:

颅脑CT/MR

Measure time point of outcome:

48h

Measure method:

Brain CT/MR

指标中文名:

早期神经功能改善比例

指标类型:

次要指标

Outcome:

The proportion of early improvement in neurological function

Type:

Secondary indicator

测量时间点:

随机后48小时

测量方法:

NIHSS评分量表

Measure time point of outcome:

48 hours after randomization

Measure method:

NIHSS Rating scale

指标中文名:

90天mRS评分0-3分比例(%)

指标类型:

次要指标

Outcome:

Proportion (%) of patients with 90-day mRS score of 0-3 points

Type:

Secondary indicator

测量时间点:

随机后90天

测量方法:

mRS评分量表

Measure time point of outcome:

After randomization for 90 days

Measure method:

mRS scoring scale

指标中文名:

90天mRS评分0-2分比例(%)

指标类型:

次要指标

Outcome:

Proportion (%) of patients with 90-day mRS score of 0-2 points

Type:

Secondary indicator

测量时间点:

随机后90天

测量方法:

mRS评分量表

Measure time point of outcome:

After randomization for 90 days

Measure method:

mRS scoring scale

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 100 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):

由第三方生物统计学专家采用SAS9.4软件按1:1比例产生随机分组序列号。筛选评估的合格受试者按照1:1比例被随机分成两组。各分中心研究者在患者签署知情同意书后报告组长单位研究者,后者通过“金陵鼠”APP实现随机化分组。

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

Randomization sequence numbers were generated at a 1:1 ratio by a third-party biostatistician using SAS9.4 software. Eligible subjects for screening assessment were randomly divided into two groups in a 1:1 ratio. After patients provided written informed consent, the subsite investigator reported to the lead investigator, who used the Jinlingmouse APP to perform randomization.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

开放标签,对评估者设盲

Blinding:

Open-label study with blinded-evaluators

是否共享原始数据:

IPD sharing

否No

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):

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

NONE

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EpiData软件编制数据录入程序,进行数据录入与管理。

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

EpiData software was used to compile the data entry program for data entry and management.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-05-13 14:41:24