颅内动脉粥样硬化性卒中患者血管内治疗术后静脉泵入替罗非班48 h对患者预后的影响  

Effect of intravenous pumping of tirofiban for 48 hours on prognosis of intracranial atherosclerotic stroke patients after intravascular therapy

作　　者：徐松 李明超[1] XU Song;LI Mingchao(Huai’an First Hospital Affiliated to Nanjing Medical University,Huai’an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300

出　　处：《中国实用神经疾病杂志》2024年第12期1476-1480,共5页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金项目(编号:82060166)。

摘　　要：目的探究急性颅内动脉粥样硬化性狭窄所致大血管闭塞(ICAS-O)患者血管内治疗(EVT术后静脉泵入替罗非班48 h的疗效和安全性。方法回顾性分析2021-06—2023-08南京医科大学附属淮安第一医院接受EVT的133例患者,62例术后替罗非班静脉泵入48 h(替罗非班48 h组),71例替罗非班静脉泵入24 h(替罗非班24 h组),分析2组90 d预后、脑内出血(ICH)、症状性脑内出血(sICH)及90 d时病死率。采用二元Logistic回归分析90 d良好预后的影响因素。结果与替罗非班24 h组比较,替罗非班48 h组90 d时具有更高的良好预后率(51.6%比32.4%,P=0.025),2组患者ICH、sICH、90 d时病死率差异无统计学意义(P>0.05)。静脉泵入替罗非班48 h(OR=2.957,95%CI:1.377~6.353,P=0.004)与患者90 d良好预后存在独立相关性。结论急性ICAS-O患者EVT术后静脉泵入替罗非班48 h较24 h可更显著改善患者90 d临床转归,且不会增加sICH风险。Objective To investigate the efficacy and safety of 48-hour intravenous tirofiban administration following endovascular therapy(EVT)in patients with acute intracranial atherosclerotic stenosis-related large vessel occlusion(ICAS-O).Methods A retrospective analysis was conducted on 133 patients who underwent EVT at the Huai’an First Hospital Affiliated to Nanjing Medical University from June 2021 to August 2023.Sixty-two patients received 48 hours of intravenous tirofiban post-procedure(48-hour tirofiban group),while 71 patients received 24 hours(24-hour tirofiban group).The 90-day outcomes,intracranial hemorrhage(ICH),symptomatic intracranial hemorrhage(sICH)and 90-day mortality rate of the two groups were analyzed.Binary Logistic regression was used to analyze the factors influencing favorable outcomes at 90 days.Results Compared to the 24-hour tirofiban group,the 48-hour tirofiban group had a higher rate of favorable outcomes at 90 days(51.6%vs 32.4%,P=0.025).There were no statistically significant differences in ICH,sICH,and 90-day mortality rates between the two groups(P>0.05).48-hour tirofiban infusion was significantly independently associated with favorable 90-day outcomes(OR=2.957,95%CI:1.377-6.353,P=0.004).Conclusion For patients with acute ICAS-O undergoing EVT,48-hour tirofiban infusion can significantly improve 90-day clinical outcomes without increasing the risk of sICH.

关 键 词：颅内动脉粥样硬化性狭窄 血管内治疗 替罗非班 预后 脑内出血 症状性脑内出血 

分 类 号：R743[医药卫生—神经病学与精神病学]