序贯替罗非班治疗对溶栓后小动脉闭塞型脑梗死的临床疗效研究OACSTPCD
Clinical efficacy of sequential tirofiban in acute ischemic stroke with small artery occlusion after thrombolysis
目的 探讨序贯替罗非班治疗对静脉溶栓后小动脉闭塞型脑梗死(SAO)的安全性和有效性.方法 回顾性收集2019 年12 月至2022 年6 月在长治医学院附属和济医院神经内科时间窗内行静脉溶栓治疗的小动脉闭塞型脑梗死患者90 例,分为观察组(接受替罗非班、常规抗血小板聚集、调脂稳斑)和对照组(常规抗血小板聚集、调脂稳斑).通过倾向性评分匹配法平衡基线特征差异.主要评价指标是远期预后,即发病3 个月时预后良好(mRS≤2 分)的比率.次要结果是早期神经功能损害及临床疗效.结果 3 个月时,替罗非班组的远期功能良好结局优于对照组(P>0.05).与对照组相比,替罗非班组的早期神经功能NIHSS评分明显降低(P<0.05).在第7d,接受替罗非班治疗的总有效率明显高于对照组(P<0.05),第14d仍明显高于对照组(P<0.05).结论 溶栓后序贯替罗非班治疗对SAO是安全有效的,可能是AIS患者溶栓再通治疗的补救措施.
Objective To explore the safety and efficacy of sequential tirofiban in patients with small artery occlusion(SAO)cerebral infarction after intravenous thrombolysis.Methods A retrospective collection of 90 cases of small artery occlable cerebral infarction who underwent intravenous thrombolytic treatment within the time window at the Department of Neurology,Heji Hospital,Affiliated to Changzhi Medical College from December 2019 to June 2022.It was divided into observation group(receiving tirofiban,conventional antiplatelet aggregation,lipid regulation and stabilization)and control group(conventional antiplatelet aggregation,lipid regulation and plaque stabilization).Baseline feature differences were balanced by propensity score matchingd.The main evaluation index was the long-term prognosis,the ratio of good prognosis(mRS≤2 points)at 3 months.The secondary outcome was early neurological impairment and clinical outcome.Results At 3 months,the long-term functional outcome of the tirofiban group was better than that of the control group(P>0.05).Compared with the control group,the early neurological function NIHSS score of the tirofiban group was significantly reduced(P<0.05).On the 7th day,the total efficiency of tirofiban treatment was higher than that of the control group(P<0.05).On the 14th day,the data was still significantly higher(P<0.05).Conclusion Sequential tirofiban treatment after thrombolysis is safe and effective for SAO,which may be the remedial treatment of AIS patients after thrombolysis and recanalization.
贾丽雅;张金;牛腾飞
030001 太原,山西医科大学第一临床医学院山西医科大学第一医院神经内科长治医学院附属和济医院神经内科
临床医学
替罗非班静脉溶栓急性缺血性卒中小动脉闭塞
tirofibanintravenous thrombolysisacute ischemic strokesmall artery occlusion
《临床神经病学杂志》 2024 (003)
174-178 / 5
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