替罗非班治疗高龄急性缺血性脑卒中患者经阿替普酶静脉溶栓后血管再闭塞的有效性及安全性  

Effectiveness and safety of tirofiban in the treatment of vascular re-occlusion after intravenous thrombolysis with alteplase for elderly acute ischemic stroke patients

作　　者：吕洋 李宏伟 柳燕 宋金东 薛慧 LYU Yang;LI Hongwei;LIU Yan;SONG Jindong;XUE Hui(Department of Neurology,Traditional Chinese Medical Hospital of Huangdao District in Qingdao,Shandong Province,Qingdao 266500,China;不详)

机构地区：[1]山东省青岛市黄岛区中医医院神经内科,266500 [2]山东第一医科大学(山东省医学科学院)生物医学科学学院(省医药生物技术研究中心),济南市250014 [3]山东省青岛市黄岛区中心医院门诊部,266500

出　　处：《临床合理用药杂志》2024年第6期13-17,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：青岛市2020年度医药科研项目(2020-WJZD241)。

摘　　要：目的观察替罗非班治疗高龄急性缺血性脑卒中(AIS)患者经阿替普酶静脉溶栓后血管再闭塞的有效性及安全性。方法前瞻性选取2020年1月—2022年7月青岛市黄岛区中医医院神经内科收治的124例高龄AIS静脉溶栓后血管再闭塞患者作为研究对象,按照随机数字表法将患者分为常规组62例和替罗非班组62例。常规组患者予以常规治疗,替罗非班组在常规治疗基础上予以替罗非班。比较2组患者治疗7 d后美国国立卫生研究院卒中量表(NIHSS)评分,治疗90 d后改良Rankin量表(mRS)评分及预后良好,出血性转化(HT)、症状性颅内出血(SICH)、病死率。结果替罗非班组患者治疗7 d后NIHSS评分及治疗90 d后mRS评分低于常规组,治疗90 d后预后良好率高于常规组(P<0.05或P<0.01)。常规组与替罗非班组患者治疗后HT、SICH发生率及病死率比较,差异均无统计学意义(P>0.05)。结论采用替罗非班治疗高龄AIS经阿替普酶静脉溶栓后血管再闭塞患者有效,可有效减轻患者神经功能及日常生活能力,且有利于改善患者预后。Objective To explore the effectiveness and safety of tirofiban in the treatment of vascular re-occlusion after intravenous thrombolysis with alteplase for elderly AIS patients.Methods A total of 124 cases of elderly AIS patients complicated with vascular re-occlusion after intravenous thrombolysis with alteplase were selected from January 2020 to July 2022 in Department of Neurology,Traditional Chinese Medical Hospital of Huangdao District in Qingdao,and they were divided into the conventional group and the tirofiban group,with 62 patients in each group.Patients in the conventional group were given conventional therapy,and patients in the tirofiban group were given tirofiban based on the conventional group.NIHSS score after 7 days of treatment,mRS score and incidence of good prognosis after 90 days of treatment,incidence of HT,SICH and mortality were compared between the two groups.Results NIHSS score after 7 days of treatment and mRS score after 90 days of treatment of the tirofiban group were lower than those of the conventional group,incidence of good prognosis after 90 days of treatment was higher than that of the conventional group(P<0.05 or P<0.01).There was no significant difference of incidence of HT,SICH and mortality between the conventional group and the tirofiban group(P>0.05).Conclusion Tirofiban is effective in the treatment of vascular re-occlusion after intravenous thrombolysis with alteplase for elderly AIS patients,which can effectively improve the neurological function and daily living ability of patients,and improve the prognosis of patients.

关 键 词：急性缺血性脑卒中 高龄 血管再闭塞 替罗非班 阿替普酶 静脉溶栓 出血性转化 症状性颅内出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]