替罗非班用于急性颅内宽颈动脉瘤破裂患者的临床研究  

Clinical trial of tirofiban in the treatment of patients with acutely ruptured wide-necked intracranial aneurysms

作　　者：蒙智恩[1] 郭世军[1] 韦定 韦扬韬[2] MENG Zhi-en;GUO Shi-jun;WEI Ding;WEI Yang-tao(Department of Neurosurgery,The Third People's Hospital of Hechi City,Hechi 547000,Guangxi Zhuang Autonomous Region,China;Department of Neurology,The Third People's Hospital of Hechi City,Hechi 547000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]河池市第三人民医院神经外科,广西壮族自治区河池547000 [2]河池市第三人民医院神经内科,广西壮族自治区河池547000

出　　处：《中国临床药理学杂志》2024年第19期2771-2775,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察替罗非班用于急性颅内宽颈动脉瘤破裂患者支架辅助弹簧圈栓塞(SAC)治疗的临床疗效及安全性。方法将接受SAC治疗的急性颅内宽颈动脉瘤破裂患者按队列法分为对照组和试验组。对照组术前2 h给予阿司匹林肠溶片300 mg,qd和硫酸氢氯吡格雷片300 mg,qd。试验组术中给予盐酸替罗非班氯化钠注射液10μg·kg^(-1),10 min内匀速静脉推注,随后以0.1μg·kg^(-1)·min^(-1)的速度持续泵入12~24 h。比较2组患者的临床疗效、血小板活化功能[血小板α颗粒膜糖蛋白(CD62p)阳性率、血小板黏附率、血小板聚集率],及围术期并发症情况;术后6个月随访,记录2组患者的格拉斯哥预后(GOS)评分及疾病复发率,以及安全性。结果试验组和对照组分别入组53例和47例。治疗后,试验组和对照组的栓塞介入治疗总有效率分别为91.49%(43例/47例)和81.13%(43例/53例),在统计学上差异无统计学意义(P>0.05)。术后第7天,试验组和对照组的CD62p阳性率分别为(56.31±7.41)%和(60.71±7.38)%,血小板黏附率分别为(37.56±3.64)%和(38.04±3.89)%,血小板聚集率分别为(27.03±3.39)%和(30.19±3.63)%,试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。术后6个月随访期间,试验组和对照组的预后良好率分别为89.36%和81.13%,疾病复发率分别为4.26%和9.43%,试验组的上述指标与对照组比较,在统计学上差异均无统计学意义(均P>0.05)。2组患者的围术期并发症均以动脉瘤再破裂出血、皮下瘀斑、牙龈出血、血栓事件等为主。试验组和对照组的并发症总发生率分别为10.64%和28.30%,在统计学上差异有统计学意义(P<0.05)。结论盐酸替罗非班氯化钠注射液可有效减少急性颅内宽颈动脉瘤破裂患者SCA围术期血栓事件的发生率,改善血小板活化功能。Objective To observe the clinical efficacy and safety of tirofiban in stent-assisted coil(SAC)embolization for patients with acutely ruptured wide-necked intracranial aneurysms.Methods Patients with acutely ruptured wide-necked intracranial aneurysms who underwent SAC embolization were divided into the control group and the treatment group according to cohort method.The control group was treated with aspirin enteric-coated tablets(300 mg,qd)and clopidogrel bisulfate tablets(300 mg,qd,oral administration)at 2 h before surgery.The treatment group was treated with tirofib an hydrochloride and sodium chloride injection at 10μg·kg^(-1)during surgery,which was administrated via intravenous injection at a constant speed within 10 min.Then,the injection rate was adjusted to 0.1μg·kg^(-1)·min^(-1)for 12-24 h.The two groups were compared on clinical efficacy,platelet activation function[platelet alpha granule membrane glucoprotein(CD62p)positive rate,platelet adhesion rate and platelet aggregation rate],and perioperative complications.The patients were followed up for 6 months after surgery.The Glasgow Outcome Scale(GOS)scores,recurrence rate and safety were recorded.Results Fifty-three cases and forty-seven cases were included in the treatment group and the control group,respectively.After treatment,the total effective rates of embolization in the treatment group and the control group were 91.49%(43 cases/47 cases)and81.13%(43 cases/53 cases),without statistically significant difference(P>0.05).On day 7 after surgery,CD62p positive rates were(56.31±7.41)%and(60.71±7.38)%;platelet adhesion rates were(37.56±3.64)%and(38.04±3.89)%;platelet aggregation rates were(27.03±3.39)%and(30.19±3.63)%.The differences in above indicators between the treatment group and the control group were statistically significant(all P<0.05).During6 months of follow-up,the good prognosis rates in the treatment group and the control group were 89.36%and81.13%;recurrence rates were 4.26%and 9.43%.There were not statistically significant dif

关 键 词：盐酸替罗非班氯化钠注射液 急性颅内宽颈动脉瘤 颅内破裂动脉瘤 支架辅助弹簧圈栓塞术 安全性评价 

分 类 号：R972[医药卫生—药品]