尿激酶介导的静脉溶栓后早期给予替罗非班可减少动脉粥样硬化性分支病变患者的早期神经功能恶化。
Early administration of tirofiban after urokinase-mediated intravenous thrombolysis reduces early neurological deterioration in patients with branch atheromatous disease.
机构信息
Department of Neurology, Suzhou First People's Hospital, Suzhou, Anhui Province, China.
Department of Neurology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China.
出版信息
J Int Med Res. 2020 May;48(5):300060520926298. doi: 10.1177/0300060520926298.
OBJECTIVES
To investigate the effects of early administration of tirofiban after intravenous thrombolysis on early neurological deterioration in patients with branch atheromatous disease.
METHODS
We analyzed clinical data from patients with branch atheromatous disease. We enrolled seven cases into the urokinase-only (UO) control group and 10 cases into the urokinase + tirofiban (UT) treatment group. National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission and on days 3 and 5 after admission. Modified Rankin Scale (mRS) scores were obtained 3 months after admission.
RESULTS
Significant differences between the UO and UT groups were evident on days 3 and 5 after admission. In the UT group, there was a significant difference between NIHSS scores at admission and on day 5, while there were no significant differences in scores in the UO group. The early neurological deterioration rates were not significantly different between the two groups. However, there were significant differences in these rates at 72 and 120 hours. Both the mRS scores and the prognoses at 3 months differed between the two groups.
CONCLUSION
Early administration of tirofiban after urokinase-mediated intravenous thrombolysis reduces early neurological deterioration and improves the long-term prognosis of patients with branch atheromatous disease.
目的
探讨阿替普酶溶栓后早期应用替罗非班对动脉粥样硬化性分支血管病变患者早期神经功能恶化的影响。
方法
回顾性分析动脉粥样硬化性分支血管病变患者的临床资料。将单纯尿激酶溶栓组（Urokinase-only，UO）7 例患者纳入对照组，尿激酶联合替罗非班组（Urokinase + tirofiban，UT）10 例患者纳入治疗组。入院时、入院后第 3、5 天采用美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分，入院后第 3 个月采用改良 Rankin 量表（modified Rankin Scale，mRS）评分。
结果
入院后第 3、5 天两组间 NIHSS 评分比较差异有统计学意义，UT 组入院时与入院后第 5 天 NIHSS 评分比较差异有统计学意义，UO 组入院后 NIHSS 评分比较差异无统计学意义。两组早期神经功能恶化发生率比较差异无统计学意义，但 72、120 h 两组间差异有统计学意义。两组 mRS 评分及 3 个月预后比较差异有统计学意义。
结论
阿替普酶溶栓后早期应用替罗非班可减少动脉粥样硬化性分支血管病变患者早期神经功能恶化，改善患者预后。
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