替罗非班桥接静脉溶栓治疗急性缺血性卒中的临床疗效
Tirofiban Combined with Intravenous Thrombolysis in Treatment of Acute Ischemic Stroke
周京辉 1叶启桦 1杨敏 1武庆利 2郑书恭3
作者信息
- 1. 广东省东莞市大朗医院 药学部(523770)
- 2. 广东省东莞市大朗医院 放射科(523770)
- 3. 广东省东莞市大朗医院 神经内科(523770)
- 折叠
摘要
目的:探讨急性缺血性卒中(AIS)应用阿替普酶(rt-PA)静脉溶栓后12h内桥接替罗非班治疗的临床疗效.方法:选取2019年1月至2022年12月广东省东莞市大朗医院神经内科诊治的发病＜6h的AIS患者120例为研究对象,随机分为对照组和研究组各60例.对照组给予rt-PA静脉溶栓治疗,研究组在静脉溶栓后12h内桥接替罗非班治疗,比较两组治疗前、后的神经功能、磁共振弥散加权成像(DWI)结果;并随访3个月,比较两组预后情况.结果:治疗24 h、14 d后,研究组神经功能损伤(NIHSS)评分明显低于对照组(P＜0.05),两组出血发生率无明显差异(P＞0.05).磁共振DWI结果显示研究组有效率明显高于对照组(81.67%vs 65.0%,P＜0.05).治疗后90d研究组mRS评分明显低于对照组(P＜0.05).结论:AIS患者在rt-PA静脉溶栓后12h内桥接替罗非班治疗,能有效减轻患者的神经功能损伤,预防血栓再形成,改善其预后.
Abstract
Objective:To explore the clinical effect of intravenous thrombolytic therapy of alteplase(rt-PA)com-bined with tirofiban within 12 h after acute ischemic stroke(AIS).Methods:120 patients with AIS diagnosed and treat-edless than 6 hours in the Department of Neurology inthe hospital from Jan 2019 to Dec 2022 were randomly divided into control group and study group,and each group was 60 cases.The two groups were given intravenous thrombolytic therapy withrt-PA,and the study group was treated with tirofiban within 12 h after intravenous thrombolytic therapy.The neuro-logical injury and the results of Diffusion weigh ted imaging(DWI)were compared between the two groups before and af-terof treatment.At the same time,the two groups were followed up for 3 months to compare the prognosis.Results:After 24 hours、14 days of the treatment,the neurological impairment(NIHSS)score in the study group was significantly lower than that in the control group(P＜0.05),and there was no significant difference in the incidence of bleeding between the two groups(P＞0.05).The results of magnetic resonance DWI showed that the effective rate in the study group was signifi-cantly higher than that in the control group(81.67%vs.65.0%,P=0.039).The mRS score was significantly lower in the study group than that in the control group at 90d after treatment(P＜0.05).Conclusion:The combination ofrt-PA with ti-rofiban within 12 h after intravenous thrombolytic therapy can effectively reduce the neurological injury,prevent thrombo-sis and improve the prognosis of patient with AIS.
关键词
急性缺血性脑卒中/静脉溶栓/替罗非班/磁共振弥散加权成像/疗效Key words
acute ischemic stroke/intravenous thrombolytic therapy/tirofiban/magnetic resonance imaging diffu-sion weigh ted imaging/clinical effect引用本文复制引用
基金项目
广东省东莞市社会发展科技面上项目(20211800901172)
出版年
2024
NETL
NSTL
万方数据