替罗非班在支架辅助颅内动脉瘤栓塞中的应用效果及对血清sICAM-1水平的影响研究  

Study on application effect of tirofiban in stent assisted intracranial aneurysm embolization and its influence on serum sICAM-1 levels

作　　者：李海堃 LI Hai-kun(Department of Neurosurgery,Huidong County People's Hospital,Huizhou 516300,China)

机构地区：[1]惠东县人民医院神经外科,516300

出　　处：《中国现代药物应用》2024年第12期108-111,共4页Chinese Journal of Modern Drug Application

基　　金：惠州市科学技术局立项(项目编号:2022CZ010362)。

摘　　要：目的探讨替罗非班在支架辅助颅内动脉瘤栓塞中的应用效果及对血清可溶性细胞间粘附分子1(sICAM-1)水平的影响。方法拟行支架辅助颅内动脉瘤栓塞治疗的60例颅内动脉瘤患者,使用随机数字表法将所有患者按入院时编号分组,奇数者纳入小剂量组,偶数者纳入大剂量组。小剂量组患者接受0.15μg/(kg·min)替罗非班静脉泵注3 min,大剂量组接受3μg/(kg·min)替罗非班静脉泵注3 min。所有患者均在全身麻醉(全麻)下接受支架辅助颅内动脉瘤栓塞治疗。比较两组患者临床疗效、凝血功能[血小板计数(PLT)、活化部分凝血活酶时间(APTT)]、术后不良事件发生情况、血清sICAM-1水平。结果术后21 d,两组患者新发梗阻率、支架通畅率比较差异无统计学意义(P>0.05)。小剂量组中5例支架不通畅的患者以及大剂量组中6例支架不通畅的患者进行Raymond法分级,两组Raymond法分级比较差异无统计学意义(P>0.05)。术后21 d,两组患者PLT、APTT比较差异无统计学意义(P>0.05)。小剂量组患者术后不良事件发生率为6.67%,低于大剂量组患者的26.67%,差异有统计学意义(P<0.05)。术前和术后1 d,两组患者血清sICAM-1水平比较差异无统计学意义(P>0.05);术后7、21 d,小剂量组患者血清sICAM-1水平分别为(145.73±2.21)、(131.82±1.43)ng/ml,高于大剂量组患者的(139.83±1.84)、(127.83±1.32)ng/ml,差异有统计学意义(P<0.05)。结论对于行支架辅助颅内动脉瘤栓塞治疗的患者,小剂量替罗非班的临床应用效果与大剂量相当,但小剂量应用替罗非班的出血风险更低,安全性更好,这可能与血清sICAM-1水平相对较高有关。Objective To investigate the application of tirofiban in stent assisted intracranial aneurysm embolization and its influenece on serum soluble intercellular adhesion molecule-1(sICAM-1)levels.Methods 60 patients planned to undergo stent assisted intracranial aneurysm embolization treatment were selected as the research subjects.The patients were numbered by random number table method at admission,with odd-numbered patients included in the low-dose group and even-numbered patients included in the high-dose group.Patients in the low-dose group received 0.15μg/(kg·min)tirofiban intravenous pumped for 3 min,and those in the high-dose group received 3μg/(kg·min)tirofiban intravenous pumped for 3 min.All patients received stent assisted intracranial aneurysm embolization under general anesthesia.The clinical efficacy,coagulation function[platelet count(PLT),activated partial thromboplastin time(APTT)],postoperative adverse events and serum sICAM-1 level were compared between the two groups.Results At 21 d after surgery,there was no significant difference in the rate of new obstruction and stent patency between the two groups(P>0.05).5 patients with stent obstruction in the low-dose group and 6 patients with stent obstruction in the high-dose group were graded by the Raymond method,and there was no statistically significant difference in the comparison of Raymond grading between the two groups(P>0.05).At 21 d after surgery,there was no significant difference in PLT and APTT between the two groups(P>0.05).The incidence of postoperative adverse events in low-dose group was 6.67%,which was lower than 26.67%in high-dose group,and the difference was statistically significant(P<0.05).There was no significant difference in serum sICAM-1 level between the two groups before surgery and at 1 d after surgery(P>0.05).At 7 and 21 d after surgery,the serum sICAM-1 levels in low-dose group were(145.73±2.21)and(131.82±1.43)ng/ml,which were higher than(139.83±1.84)and(127.83±1.32)ng/ml in high-dose group,respectively,and the dif

关 键 词：替罗非班 颅内动脉瘤 栓塞 凝血功能 可溶性细胞间粘附分子 

分 类 号：R969[医药卫生—药理学]