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机械性动脉再通后静脉注射标准剂量替罗非班在急性缺血性卒中中是安全且相对有效的。

Intravenous Administration of Standard Dose Tirofiban after Mechanical Arterial Recanalization is Safe and Relatively Effective in Acute Ischemic Stroke.

作者信息

Cheng Zhe, Geng Xiaokun, Gao Jie, Hussain Mohammed, Moon Seong-Jin, Du Huishan, Ding Yuchuan

机构信息

1Department of Neurology, Beijing Luhe Hospital, Capital Medical University, China.

2China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China.

出版信息

Aging Dis. 2019 Oct 1;10(5):1049-1057. doi: 10.14336/AD.2018.0922. eCollection 2019 Oct.

DOI:10.14336/AD.2018.0922
PMID:31595202
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6764734/
Abstract

To investigate the safety and efficacy of intravenous administration of a standard dose of glycoprotein-IIb/IIIa inhibitor tirofiban after vessel recanalization by mechanical thrombectomy in acute ischemic stroke. A consecutive series of patients (n=112) undergoing endovascular ischemic stroke intervention therapy were enrolled. 81 patients were eligible for intravenous (IV) tirofiban treatment for 24 hours after mechanical thrombectomy. The incidence of symptomatic intracranial hemorrhage (sICH), death, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) were assessed. In the 81 patients receiving tirofiban, 52 patients (64.2%) were treated with IV rt-PA before mechanical thrombectomy. sICH was found in 2 (2.5%) patients with no fatal ICH. Four patients died during 3 months after stroke onset. Successful recanalization with thrombolysis in cerebral infarction (TICI) score ≥2b was achieved in 75 of 81 patients (92.6%) after mechanical thrombectomy. The average number of passes with Solitaire stent retriever was 1.3. At 3 months, 55 of 81 patients (67.9%) had favorable outcomes (mRS<=2). The intravenous application of a standard dose of tirofiban post-Solitaire stent retriever thrombectomy and intravenous thrombolysis appears to be safe and relatively effective in acute ischemic stroke.

摘要

探讨急性缺血性卒中机械取栓血管再通后静脉注射标准剂量糖蛋白IIb/IIIa抑制剂替罗非班的安全性和有效性。纳入一系列连续接受血管内缺血性卒中干预治疗的患者(n = 112)。81例患者在机械取栓后有资格接受替罗非班静脉注射治疗24小时。评估症状性颅内出血(sICH)、死亡、美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)的发生率。在接受替罗非班治疗的81例患者中,52例(64.2%)在机械取栓前接受了静脉注射rt-PA治疗。2例(2.5%)患者出现sICH,无致命性颅内出血。4例患者在卒中发病后3个月内死亡。81例患者中有75例(92.6%)在机械取栓后成功实现脑梗死溶栓再通(TICI)评分≥2b。使用Solitaire支架取栓器的平均次数为1.3次。3个月时,81例患者中有55例(67.9%)预后良好(mRS<=2)。在急性缺血性卒中中,Solitaire支架取栓器血栓切除术后静脉应用标准剂量替罗非班及静脉溶栓似乎是安全且相对有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b515/6764734/d2d7118a5202/ad-10-5-1049-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b515/6764734/e7a756188b90/ad-10-5-1049-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b515/6764734/d2d7118a5202/ad-10-5-1049-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b515/6764734/e7a756188b90/ad-10-5-1049-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b515/6764734/d2d7118a5202/ad-10-5-1049-g2.jpg

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本文引用的文献

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Wake-up stroke: Dawn of a new era.唤醒型卒中:新时代的曙光。
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Why not Intravenous Thrombolysis in Patients with Recurrent Stroke within 3 Months?为何不在3个月内复发性卒中患者中进行静脉溶栓治疗?
多中心、开放、随机对照临床试验的统计分析计划,旨在评估静脉注射替罗非班与阿司匹林在血管内治疗(ATILA 试验)后因串联病变导致的急性缺血性脑卒中患者中的疗效和安全性。
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