[1]高擎.急性大血管闭塞性卒中静脉溶栓桥接机械取栓中应用替罗非班的疗效及安全性分析[J].徐州医科大学学报,2019,39(08):551-556.
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急性大血管闭塞性卒中静脉溶栓桥接机械取栓中应用替罗非班的疗效及安全性分析()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
39
期数:
2019年08期
页码:
551-556
栏目:
出版日期:
2019-08-25

文章信息/Info

Title:
Efficacy and safety of tirofiban in the bridging therapy of mechanical thrombectomy after intravenous thrombolysis for acute ischemic stroke with main artery occlusion.
作者:
高擎
文献标志码:
A
摘要:
目的 探讨 替罗非班在急性大血管闭塞性卒中且行静脉溶栓桥接机械取栓治疗患者中应用的疗效及安全性。方法 回顾性分析我院卒中数据库自2016年1月至2019年1月收治的121例诊断为急性大血管闭塞性卒中且行桥接治疗患者的临床资料,其中取栓术中及术后使用替罗非班治疗的患者(替罗非班组)共45例,取栓术中及术后未使用替罗非班治疗的患者(标准治疗组) 共76例。通过分析两组患者的基线资料、术后24小时及术后7天的美国国立卫生研究院卒中量表评分、30天及90天的改良Rankin量表评分、术后改良心肌梗死溶栓试验血流分级、术后血管再闭塞率、术后症状性颅内出血发生率、术后消化道出血发生率、3个月内死亡率等,评估两种治疗方案的有效性和安全性。 结果 术后替罗非班组血流再通率、7天NIHSS评分、30天及90天mRS评分、血管再闭塞率均明显优于标准治疗组(P<0.05),两组SICH发生率、消化道出血发生率、3个月内死亡率差异无统计学意义(P>0.05)。结论 急性大血管闭塞性卒中患者桥接术中及术后使用替罗非班,可提高血管再通率,改善预后,降低血管再闭塞率,且不增加出血风险。
Abstract:
s: Objective To evaluate the efficacy and safety of tirofiban in the bridging therapy of mechanical thrombectomy after intravenous thrombolysis for acute ischemic stroke with main artery occlusion . Methods A retrospective analysis was performed on the clinical data of 121 patients diagnosed as acute ischemic stroke with main artery occlusion and treated with bridging therapy in the stroke database of our hospital from January 2016 to January 2019. 45 patients were treated with tirofiban during and after thrombectomy (tirofiban group), and 76 patients were not(standard treatment group). Baseline data of the two groups, scores of the National Institutes of Health Stroke Scale (NIHSS) 24 hours and 7 days after thrombectomy, Modified Rankin Score (mRS) scores at days 30 and days 90 , blood flow fractionation of Modified thrombolysis in myocardial infarction(mTICI) after thrombectomy, vascular re-occlusion rate, incidence of symptomatic intracranial hemorrhage(SICH), incidence of gastrointestinal hemorrhage and 3-month mortality were analyzed to assess the efficacy and safety of the two treatment options. Results The blood flow fractionation, 7-day NIHSS score, 30-day mRS score and 90-day mRS score of the tirofiban group were significantly better than those of the standard treatment group (P<0.05), while the SICH incidence, gastrointestinal hemorrhage incidence and 3-month mortality rate of the two groups were not statistically significant (P>0.05). Conclusion The use of tirofiban during and after the bridging therapy in patients of acute ischemic stroke with main artery occlusion can improve the vascular reperfusion, improve the prognosis and reduce the rate of vascular reocclusion without increasing the risk of bleeding.
更新日期/Last Update: 2019-09-18