急性缺血性脑卒中介入治疗术中应用替罗非班的疗效分析  

Therapeutic Effect of Tirofiban in Interventional Treatment of Acute Ischemic Stroke

作　　者：陈继兴[1] 叶励超[1] 姚伯昕[1] 傅懋林[2] 王双虎[2] CHEN Ji-xing;YE Li-chao;YAO Bo-xin;FU Mao-lin;WANG Shuang-hu(Department of Neurology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian Province,362000 China;Department of Neurology,the 180th Hospital of PLA,Quanzhou,Fujian Province,362000 China)

机构地区：[1]福建医科大学附属第二医院神经内科,福建泉州362000 [2]解放军第180医院神经内科,福建泉州362000

出　　处：《中外医疗》2018年第19期14-17,共4页China & Foreign Medical Treatment

摘　　要：目的探讨急性缺血性脑卒中介入治疗术中应用替罗非班的疗效。方法方便选择2016年1月—2017年6月在福建医科大学附属第二医院及解放军第180医院行急诊介入手术的急性脑梗塞患者共84例,用随机数字表法分为替罗非班组(41例)及对照组(43例)。替罗非班组术中靶血管内注射替罗非班10μg/kg,继之以0.075μg/(kg·min)持续静脉滴注24 h;对照组不应用替罗非班。根据全脑血管造影图像观察两组患者靶血管TICI血流分级情况,并观察两组术前,术后24 h、7 d的NIHSS评分,90 d改良Rankin量表(m RS)评分。结果动脉内注射药物后首次及手术结束前末次造影显示:替罗非班组TICI 2b^3级血流比例(63.4%、73.2%)均高于对照组(39.5%、44.2%),两组间差异有统计学意义(χ~2=4.79,P<0.05;χ~2=7.25,P<0.01);替罗非班组术后24 h及7 d NIHSS评分[(6.51±3.67)分、(4.13±1.57)分]均低于对照组[(9.22±4.52)分、(7.98±2.74)分],两组间差异有统计学意义(t=3.01,P<0.01、t=7.85,P<0.01);替罗非班组90 d m RS评分0~2分比例65.9%高于对照组37.2%,两组间差异有统计学意义(χ~2=6.89,P<0.01)。结论急性缺血性脑卒中患者介入治疗中采取替罗非班贯续治疗能有效改善患者血流灌注,改善近期及远期预后,是AIS患者术中出现灌注不良或"无复流"的一种有效的治疗方法。Objective This paper tries to observe the effect of tirofiban in interventional treatment of acute ischemic stroke.Methods A total of 84 patients with acute cerebral infarction undergoing emergency intervention surgery from the Second Affiliated Hospital of Fujian Medical University and the 180 th Hospital of People＇s Liberation Army from January 2016 to June 2017 were selected conveniently and divided into tirofiban group（41 cases） using a random number table method, and control group（43 cases）. In the tirofiban group, tirofiban was intratumorally injected with 10 μg/kg intraoperatively, followed by continuous intravenous infusion of 0.075 μg/（kg·min） for 24 hours. Tirofiban was not administered in the control group.According to the whole cerebral angiograms, the TICI blood flow grading of the target vessels in the two groups was observed. The NIHSS scores before and 24 h and 7 d after operation and the 90 d Modified Rankin Scale（m RS） scores were observed. Results After the first intra-arterial injection of the drug and before the end of the operation, the last angiography showed： the proportion of TICI 2 b-3 grade blood flow（63.4%, 73.2%） was higher in the tirofiban group than in the control group（39.5%, 44.2%）. There was a statistically significant difference（χ^2=4.79, P〈0.05;χ^2=7.25, P〈0.01）. The NIHSS scores[（6.51±3.67）points,（4.13±1.57）points were lower at 24 hours and 7 days after surgery in the tirofiban group. In the control group [（9.22±4.52）points,（7.98±2.74）points], the difference between the two groups was statistically significant（t=3.01, P〈0.01;t =7.85, P〈0.01）; the tirofiban group in 90 days of m RS score 0-2 points of 65.9% higher than the control group37.2%, the difference between the two groups was statistically significant（χ^2=6.89, P〈0.01）. Conclusion The use of tirofiban in continuous interventional treatment of acute ischemic stroke patients can effectively improve blood perfusion and improve short-and long-term p

关 键 词：替罗非班 急性缺血性脑卒中 介入治疗 有效性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]