[1]曹志勇 丁妹 朱连海等.替罗非班治疗急性脑梗死静脉溶栓后24 h内不明原因早期神经功能恶化的临床研究[J].卒中与神经疾病杂志,2021,28(01):20-24.[doi:10.3969/j.issn.1007-0478.2021.01.004]
　Cao Zhiyong,Ding Mei,Zhu Lianhai,et al.Clinical study of Tirofiban in the treatment of unexplained early neurological deterioration within 24 hours after intravenous thrombolysis in patients with acute ischemic stroke[J].Stroke and Nervous Diseases,2021,28(01):20-24.[doi:10.3969/j.issn.1007-0478.2021.01.004]
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替罗非班治疗急性脑梗死静脉溶栓后24 h内不明原因早期神经功能恶化的临床研究()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第28卷
期数:
2021年01期
页码:
20-24
栏目:
论 著
出版日期:
2021-02-26

文章信息/Info

Title:
Clinical study of Tirofiban in the treatment of unexplained early neurological deterioration within 24 hours after intravenous thrombolysis in patients with acute ischemic stroke
文章编号:
1007-0478(2021)01-0020-05
作者:
曹志勇 丁妹 朱连海等
226000 江苏省南通大学第二附属医院神经内科[曹志勇 丁妹 朱连海 李新玲 汪涵 朱向阳(通信作者)]
Author(s):
Cao Zhiyong;  Ding Mei;  Zhu Lianhai;  et al.
Department of Neurology, the Second Affiliated Hospital of Nantong University, Nantong Jiangsu 226000
关键词:
阿替普酶 静脉溶栓 脑梗死 早期神经功能恶化 替罗非班 预后
Keywords:
Alteplase Intravenous thrombolysis Cerebral infarction Early neurological deterioration Tirofiban Prognosis
分类号:
R743.3
DOI:
10.3969/j.issn.1007-0478.2021.01.004
文献标志码:
A
摘要:
目的 探讨经阿替普酶静脉溶栓治疗的急性脑梗死患者在24 h内发生不明原因早期神经功能恶化(unexplained early neurological deterioration,Unexplained END)后应用替罗非班治疗的有效性和安全性。方法 回顾性分析2015年1月-2020年1月于南通大学第二附属医院急诊神经内科确诊为急性脑梗死,并在静脉溶栓时间窗内应用阿替普酶进行溶栓治疗后24 h内发生不明原因早期神经功能恶化的患者,根据是否应用替罗非班进行干预分为应用替罗非班干预的治疗组和常规治疗的对照组。应用美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评估2组患者在干预后第24 h、第7 d的神经功能缺损程度,并于出院后第90 d应用改良的Rankin量表(Modified Rankin scale,mRS)对所有患者的生活能力恢复情况进行评估,以mRS评分较出院时>2分为预后不良,mRS评分≤2分为预后良好,住院期间评估所有患者是否存在出血转化,出院后90 d是否存在死亡病例。结果 共纳入73例经静脉溶栓后发生不明原因END的急性脑梗死患者,其中男53(72.6%)例,女20(27.4%)例,平均年龄(63.33±4.53)岁,治疗组31(42.5%)例,对照组42(57.5%)例。治疗组在干预后的第24 h和第7 d的NIHSS评分均低于对照组(P<0.05); 治疗组出院后90 d预后良好的比例明显高于对照组(P<0.05)。治疗组出现2例出血转化,2组均未出现死亡病例。结论 对于经阿替普酶静脉溶栓后的急性脑梗死患者所出现的END及时应用替罗非班进行干预安全有效。
Abstract:
ObjectiveTo investigate the efficacy and safety of Tirofiban in patients with acute ischemic stroke who developed unexplained early neurological deterioration(unexplained END)within 24 hours after intravenous thrombolysis with Alteplase.Methods The patients with acute ischemic stroke were selected and analyzed retrospectively, who were diagnosed in the department of emergency neurology of the second affiliated hospital of nantong university from January 2015 to January 2020 and developed unexplained END within 24 hours after intravenous thrombolysis with Alteplase. According to whether Tirofiban was used or not, the patients were divided into treatment group(treated with Tirofiban)and control group(treated with routine treatment). The neural function defects of patients in both groups were evaluated by the national institutes of health stroke scale(NIHSS)on the 24th h and 7th d after intervention, and the daily living recovery of all patients was evaluated by the modified Rankin scale(mRS)on the 90th d after discharge(mRS score>2 points, defined poor outcome and mRS score≤2 points, denoted good outcome). During hospitalization, all patients were evaluated for hemorrhagic transformation and death in the 90 days after discharge.Results A total of 73 patients with acute ischemic stroke who developed unexplained END after intravenous thrombolysis were included, in which 53(72.6%)patients were males and 20(27.4%)were females, with an average age of(63.33±4.53)years. There were 31(42.5%)cases in treatment group and 42(57.5%)cases in control group. The NIHSS score of treatment group with Tirofiban was lower than that of control group on the 24th h and 7th d after intervention(P<0.05), and in the 90 days after discharge the proportion of good prognosis of treatment group with Tirofiban was significantly higher than that of control group(P<0.05). Only two case of treatment group developed hemorrhagic transformation, and neither group developed death.Conclusion Timely intervention with Tirofiban was safe and effective for unexplained END in patients with acute ischemic stroke after intravenous thrombolysis with Alteplase.

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备注/Memo

备注/Memo:
基金项目:南通市科技局民生科技面上项目(MS12018042); 江苏省卫生健康委员会面上项目(H2019057)
更新日期/Last Update: 2021-02-26