国际神经病学神经外科学杂志2025，Vol.52Issue(4)：17-26,10.DOI:10.16636/j.cnki.jinn.1673-2642.2025.04.004
替罗非班治疗急性缺血性脑卒中疗效及安全性的荟萃分析
Efficacy and safety of tirofiban for acute ischemic stroke:a meta-analysis
摘要
Abstract
Objective To systematically evaluate the efficacy and safety of the platelet GP Ⅱb/Ⅲa receptor antagonist tirofiban in patients with acute ischemic stroke(AIS).Methods A systematic search was conducted across PubMed,Embase,Web of Science,the Cochrane Library,CNKI,VIP,and Wanfang databases for studies comparing the safety and efficacy of tirofiban versus conventional antiplatelet agents(aspirin and/or clopidogrel)for treating patients with AIS.The search covered the period from inception to June 2024.Results A total of 1 948 patients from 12 publications were included.Compared with conventional antiplatelet agents,tirofiban reduced the National Institutes of Health Stroke Scale(NIHSS)scores at 24-72 hours[SMD(95%CI)=-1.58(-2.29,-0.86),P<0.001],NIHSS scores at 7-14 days[SMD(95%CI)=-1.53(-2.24,-0.82),P<0.001],and modified Rankin Scale(mRS)scores at 90 days[WMD(95%CI)=-0.96(-1.45,-0.47),P<0.001],while increased the proportion of patients with a favorable prognosis(mRS scores of 0 to 2)at 90 days[RR(95%CI)=1.12(1.02,1.23),P<0.001].Subgroup analysis based on the timing(24,48,and 72 hours)of bridging to conventional antiplatelet therapy showed that although bridging conventional antiplatelet drugs after 72 hours of tirofiban treatment was superior to the control group in neurological outcomes,the differences were not statistically significant.There were no statistically significant differences in the incidence of cerebral hemorrhage,other bleeding events,thrombocytopenia,or mortality between the two groups.Conclusions Compared with conventional antiplatelet agents,tirofiban can improve the neurologic prognosis of patients without increasing their incidence of adverse events.关键词
急性缺血性脑卒中/替罗非班/阿司匹林/氯吡格雷/荟萃分析Key words
acute ischemic stroke/tirofiban/aspirin/clopidogrel/meta-analysis分类
医药卫生引用本文复制引用
郭欣雨,梁晨,徐培域,戴昕妤,李云涛..替罗非班治疗急性缺血性脑卒中疗效及安全性的荟萃分析[J].国际神经病学神经外科学杂志,2025,52(4):17-26,10.基金项目
江苏省医院管理创新研究项目(JSYGY-3-2024-669) （JSYGY-3-2024-669）
江苏省卫生健康委员会医学研究项目(M2022045). （M2022045）
