替罗非班治疗进展性缺血性脑卒中的疗效观察  

Therapeutic effect of tirofiban on progressive ischemic stroke

作　　者：何明峰[1] 王婷婷 高飞 田松朝[1] 马兴洲 崔会青 董歌 HE Mingfeng;WANG Tingting;GAO Fei;TIAN Songchao;MA Xingzhou;CUI Huiqing;DONG Ge(Department of Neurology,371 Central Hospital of the People's Liberation Army,Xinxiang 453000,China;Sanquan College of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]解放军第371中心医院神经内科,河南新乡453000 [2]新乡医学院三全学院,河南新乡453000

出　　处：《中国实用神经疾病杂志》2018年第20期2249-2253,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨替罗非班治疗进展性脑卒中(progressive ischemic stroke,PIS)的有效性和安全性。方法收集解放军第371中心医院神经内科2016-01—2017-12确诊的PIS并应用盐酸替罗非班氯化钠注射液治疗的5例患者,记录其人口学特征,发病时间,替罗非班应用的持续时间,不同时间点的美国国立卫生研究院卒中量表(NIHSS)评分以及并发症。结果 5例患者应用替罗非班后NIHSS评分下降4～13分,平均7.2分。在应用替罗非班注射液后血凝系列出现变化的3例,血栓弹力图均未见明显变化;5例患者在应用替罗非班前、后和应用替罗非班过程中均未出现出血并发症。结论替罗非班作为一种新型、高效、可逆的抗血小板聚集药物,通过阻断糖蛋白ⅡbⅢa受体与纤维蛋白原结合这一血小板聚集的最后、唯一途径,发挥高效的抗血小板聚集作用,其治疗PIS的价值值得进一步研究。Objective To investigate the efficacy and safety of tirofiban in the treatment of progressive ischemic stroke(PIS).Methods Five patients who were diagnosed with PIS and treated with tirofiban hydrochloride sodium chloride injection from Department of Neurology,the 371st Central Hospital of PLA form January 2016 to December 2017,recorded demographic characteristics,onset time,and application,the duration of the National Institute of Health Stroke Scale(NIHSS)scores and complications at different time points.Results In 5 patients,the NIHSS score decreased by 4 to 13 points after an application of tirofiban,with an average of 7.2 points.In the 3 cases of hemagglutination series after the application of tirofiban injection,no significant changes were observed in the thromboelastogram;5 patients did not appear the application of tirofiban before and after treatment,no bleeding complications occurred.Conclusion As a new,highly effective and reversible anti platelet aggregation drug,tirofiban exerts an effective anti platelet aggregation effect by blocking the final and only pathway of platelet aggregation in which glycoprotein IIbIIIa receptor binds to fibrinogen,its value is worth further research for the treatment of PIS.

关 键 词：进展性脑卒中 替罗非班 血凝系列 血栓弹力图 并发症 

分 类 号：R743.33[医药卫生—神经病学与精神病学]