Du Yanjiao, Li Yan, Duan Zhihui, Ma Congmin, Wang Hao, Liu Ruihua, Li Shao, Lian Yajun
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China.
J Clin Pharm Ther. 2022 Dec;47(12):2350-2359. doi: 10.1111/jcpt.13816. Epub 2022 Dec 2.
Many patients with acute ischemic stroke (AIS) develop early neurological deterioration (END), leading to disabilities or death. Thus, this study aimed to investigate the efficacy and safety of intravenous tirofiban in treating patients with AIS and END who missed the thrombolysis time window.
A total of 123 AIS-END patients participated in the study between January 2021 and December 2021. Patients were randomized into the tirofiban group (n = 63) and the control group (n = 60) based on whether a tirofiban injection was administered. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological function at the 48th hour and on the 7th day after intervention, and the modified Rankin Scale (mRS) was used to assess neurological recovery 90 days after AIS. Adverse reactions during the intervention were recorded for safety analysis.
The 7th day NIHSS and 90th day post-AIS mRS scores of the tirofiban group were significantly lower than those of the control group (p < 0.05), while the 90th day good prognosis (mRS ≤ 2) rate of the tirofiban group was significantly higher (84.13% vs. 65.00%, p < 0.05). Logistic regression demonstrated a protective effect of tirofiban for good prognosis in AIS patients with END (OR = 4.675, 95% CI [1.012-21.605], p < 0.05). No cases of intracranial haemorrhage transformation or death were observed during the treatment in either group.
Tirofiban injection exhibited a high safety profile and significantly improved the prognosis of AIS-END patients who missed the intravenous thrombolysis time window.
许多急性缺血性卒中(AIS)患者会出现早期神经功能恶化(END),导致残疾或死亡。因此,本研究旨在探讨静脉注射替罗非班治疗错过溶栓时间窗的AIS合并END患者的疗效和安全性。
2021年1月至2021年12月,共有123例AIS-END患者参与本研究。根据是否注射替罗非班,将患者随机分为替罗非班组(n = 63)和对照组(n = 60)。采用美国国立卫生研究院卒中量表(NIHSS)在干预后第48小时和第7天评估神经功能,采用改良Rankin量表(mRS)在AIS后90天评估神经功能恢复情况。记录干预期间的不良反应进行安全性分析。
替罗非班组第7天的NIHSS评分和AIS后第90天的mRS评分均显著低于对照组(p < 0.05),而替罗非班组第90天良好预后(mRS≤2)率显著更高(84.13%对65.00%,p < 0.05)。Logistic回归显示替罗非班对AIS合并END患者的良好预后具有保护作用(OR = 4.675,95%CI[1.012 - 21.605],p < 0.05)。两组治疗期间均未观察到颅内出血转化或死亡病例。
注射替罗非班安全性高,显著改善了错过静脉溶栓时间窗的AIS-END患者的预后。