替罗非班联合双联抗血小板治疗进展性卒中的临床疗效及安全性  

Clinical efficacy and safety of tirofiban combined with dual antiplatelet therapy in patients with progressive stroke

作　　者：张海奇[1] 常万生[1] 林峰[1] 鲍景蕾 潘伟[1] 尹继君[1] Zhang Haiqi;Chang Wansheng;Lin Feng;Bao Jinglei;Pan Wei;Yin Jijun(Department of Neurology,the Second People′s Hospital of Liaocheng City,the Second Hospital of Liaocheng Affiliated to Shandong First Medical University,Shandong Linqing 252600,China)

机构地区：[1]山东省聊城市第二人民医院山东第一医科大学附属聊城二院神经内科,山东临清252600

出　　处：《中国医师进修杂志》2020年第5期388-392,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨替罗非班联合双联抗血小板治疗进展性卒中的有效性和安全性,得出静脉泵入的有效时间及速度。方法收集山东第一医科大学附属聊城二院2018年6—12月进展性卒中患者,分为双抗组28例,替罗非班组22例,记录其人口学特征、脑梗死的危险因素、新发梗死部位及可能发病机制,替罗非班开始应用时机,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,静脉泵入的持续时间、维持剂量及泵入速度。记录加重后继续治疗14 d NIHSS评分,出院后90 d改良Rankin量表(mRS)评分。结果双抗组加重后继续治疗14 d,NIHSS评分下降(2.92±1.13)分,1例发生消化道出血,无颅内出血并发症。替罗非班组加重后继续治疗14 d NIHSS评分下降(3.46±1.71)分,1例发生皮肤黏膜出血,无颅内出血并发症,替罗非班静脉泵入的时间为42.2~135.7(86.6±42.3)h,泵入速度为0.15~0.45(0.31±0.12)mg/h。与双抗组比较,替罗非班组NIHSS评分及90 d mRS评分下降明显[(3.36±1.71)分比(4.75±2.30)分和(2.93±1.04)分比(3.52±1.83)分],两组比较差异有统计学意义(P<0.05)。结论静脉应用替罗非班联合双联抗血小板治疗是一种相对安全有效的治疗进展性卒中的方法。Objective To investigate the efficacy and safety of tirofiban combined with dual antiplatelet therapy for progressive stroke,and obtain the effective time and speed of intravenous tirofiban.Methods The patients with progressive stroke from June to December 2018 in the Second Hospital of Liaocheng Affiliated to Shandong First Medical University were divided into 2 groups:28 patients were treated with dual antiplatelet(dual antiplatelet group)and 22 patients were treated with tirofiban combined with dual antiplatelet(tirofiban group).The demographic characteristics,risk factors of cerebral infarction,new infarct location and possible pathogenesis were recorded.The beginning of tirofiban,National Institutes of Health stroke scale(NIHSS)score at different time points,complications,and intravenous infusion effective time,maintenance dose and speed were recorded.NIHSS score was recorded for 14 d and modified Rankin scale(mRS)score was recorded for 90 d after discharge.Results After 14 d of continuous treatment in the dual antiplatelet group,the NIHSS score decreased(2.92±1.13)scores.One case had gastrointestinal hemorrhage,and there were no intracranial hemorrhage complications.After 14 days of continuous treatment in the tirofiban group,the NIHSS score decreased(3.46±1.71)scored.One case had skin and mucosa hemorrhage,and there were no intracranial hemorrhage complications.In tirofiban group,the effective time of intravenous infusion was 42.2 to 135.7(86.6±42.3)h,and the infusion speed was 0.15 to 0.45(0.31±0.12)mg/h.Compared with the dual antiplatelet group,the NIHSS score and 90-day mRS score of tirofiban group decreased significantly:(3.36±1.71)scores vs.(4.75±2.30)scores and(2.93±1.04)scores vs.(3.52±1.83)scores,and there were statistical differences(P<0.05).Conclusions Intravenous tirofiban combined with dual antiplatelet therapy for progressive stroke may be a relatively effective method.

关 键 词：卒中 血小板 替罗非班 疗效及安全性 

分 类 号：R74[医药卫生—神经病学与精神病学]