急性脑梗死患者抗血小板治疗史对溶栓后替罗非班序贯治疗效果及安全性的影响OA
Effect of antiplatelet therapy on the efficacy and safety of tirofiban sequential therapy following thrombolysis in patients with acute ischemic stroke
目的 探讨急性脑梗死患者发病前抗血小板治疗史对于溶栓后2h使用替罗非班的有效性和安全性的影响.方法 回顾性纳入2021-03-2022-04郑州大学第二附属医院在时间窗内行溶栓治疗并在溶栓后2h使用替罗非班静脉注射治疗24～72 h的急性脑梗死患者48例.根据发病前是否正在进行抗血小板治疗将其分为抗血小板治疗组和无抗血小板治疗组.主要观察指标:(1)安全性评价:症状性颅内出血,其他部位不可控制的出血,治疗前后血小板计数及凝血相关指标的变化;(2)有效性 评 价:NIHSS评分评估短期疗效,mRS评分评估长期疗效.结果 最终共纳入患者44例,其中抗血小板治疗组和无抗血小板治疗组各 22 例.抗血小板治疗组与无抗血小板治疗组相比,治疗后 2h NIHSS评分、24 h治疗有效率差异均无统计学意义(P>0.05),2组90 d预后、90 d内复发及心脑血管疾病病死率均无统计学差异(P>0.05).2组症状性颅内出血发生率、其他部位出血率、治疗后血小板计数及凝血四项指标均无统计学差异(P>0.05).结论 发病前是否正在进行抗血小板治疗对静脉溶栓后应用替罗非班的临床结局无显著影响,不应作为静脉溶栓后应用替罗非班的禁忌证,可在临床序贯使用.
Objective To investigate the effect of pre-onset antiplatelet therapy history on the efficacy and safety of intravenous tirofiban initiated 2 hours after thrombolysis in patients with acute ischemic stroke(AIS).Methods This retrospective study included 48 AIS patients who underwent thrombolysis within the therapeutic window and subsequently received intravenous tirofiban,which was started 2 hours after thrombolysis and continued for 24-72 hours,at the Second Affiliated Hospital of Zhengzhou University between March 2021 and April 2022.Patients were divided into antiplatelet therapy group and non-antiplatelet therapy group according to whether they were receiving antiplatelet therapy before the onset of the disease.The observed primary endpoints included:① Safety:symptomatic intracranial hemorrhage,uncontrolled bleeding at other sites,the changes in platelet count and coagulation-related parameters before and after treatment.② Efficacy:short-term efficacy assessed by NIHSS score,long-term efficacy assessed by mRS score.Results Totally 44 patients were ultimately included,with 22 patients in each group(antiplatelet therapy group and non-antiplatelet therapy group).There was no significant difference in NIHSS score and effective rate at 24 hours after treatment between the two groups(P>0.05).Furthermore,there were no significant differences between the two groups in 90-day prognosis,recurrence within 90 days,or mortality from cardiovascular and cerebrovascular diseases(P>0.05).There were no significant differences in the incidence of sICH,bleeding rates at other sites,or post-treatment platelet counts and four coagulation parameters between the two groups(P>0.05).Conclusion Whether patients undergoing antiplatelet therapy before onset didn't significantly affect the clinical outcomes of tirofiban administration after intravenous thrombolysis.It should not be considered as a contraindication for tirofiban use after intravenous thrombolysis.It can be used in a sequential manner in clinical practice.
薛孟馨;王彩娥;张会;郭平平;王兆国;杨鹿奎;王亚军;李桂芳;薛孟周
河南科技大学第一附属医院,河南 洛阳 471000河南科技大学第一附属医院,河南 洛阳 471000郑州大学第二附属医院,河南 郑州 450003郑州大学第二附属医院,河南 郑州 450003河南科技大学护理学院,河南 洛阳 471000河南科技大学第一附属医院,河南 洛阳 471000河南科技大学第一附属医院,河南 洛阳 471000河南科技大学第一附属医院,河南 洛阳 471000郑州大学第二附属医院,河南 郑州 450003
医药卫生
急性脑梗死抗血小板治疗溶栓治疗替罗非班安全性有效性
Acute cerebral infarctionAntiplatelet therapyThrombolytic therapyTirofibanSafetyEffectiveness
《中国实用神经疾病杂志》 2026 (2)
195-199,5
国家自然科学基金面上项目(编号:8207133181870942)
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