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急性缺血性脑卒中患者静脉注射尿激酶溶栓后替罗非班的安全性和有效性

Safety and efficacy of tirofiban after intravenous thrombolysis with urokinase in patients with acute ischemic stroke.

作者信息

Qu Dian, Liu Huanhuan, Wei Zhongming, Cheng Yao, Fei Yutong, Xu Jinghan, Lv Xiuyu, Li Wendi

机构信息

Department of Neurology, Harbin 242 Hospital, Harbin, China.

Center of Oral Medicine, Harbin 242 Hospital, Harbin, China.

出版信息

Front Neurol. 2025 Mar 6;16:1529331. doi: 10.3389/fneur.2025.1529331. eCollection 2025.

Abstract

INTRODUCTION

Tirofiban combined with alteplase thrombolysis or endovascular therapy has been proven to improve the prognosis of patients with acute ischemic stroke (AIS). Some patients, due to the extended time window beyond 4 h and economic considerations, opt for urokinase thrombolysis instead of alteplase thrombolysis in China. However, there is currently limited research on the use of urokinase thrombolysis bridged with tirofiban.

METHODS

We employed propensity score match to pair 80 sets of patients from a total of 196 individuals who underwent urokinase thrombolysis for acute ischemic stroke. The study analyzed the 14-day National Institutes of Health Stroke Scale (NIHSS), 90-day modified Rankin Scale (mRS), bleeding events, and compared the odds ratio (OR) of patients with mRS scores of 0-2 within the subgroups.

RESULTS

The results show that the NIHSS at 14 days of the tirofiban group was significantly lower than that of the dual antiplatelet group. No significant difference was found in the proportion of patients with mRS score 0-2. The odds ratios were slightly different in subgroups classified with or without previous stroke and hypertension.

DISCUSSION

It was confirmed that the tirofiban might be safe in AIS patients received tirofiban after urokinase thrombolysis and could improve short-term neurological function.

摘要

引言

替罗非班联合阿替普酶溶栓或血管内治疗已被证明可改善急性缺血性卒中(AIS)患者的预后。在中国,一些患者由于时间窗延长至4小时以上以及经济因素,选择尿激酶溶栓而非阿替普酶溶栓。然而,目前关于尿激酶溶栓联合替罗非班应用的研究有限。

方法

我们采用倾向评分匹配法,从196例接受急性缺血性卒中尿激酶溶栓治疗的患者中配对出80组患者。该研究分析了14天的美国国立卫生研究院卒中量表(NIHSS)、90天改良Rankin量表(mRS)、出血事件,并比较了亚组内mRS评分为0 - 2的患者的比值比(OR)。

结果

结果显示,替罗非班组14天时的NIHSS显著低于双联抗血小板组。mRS评分为0 - 2的患者比例无显著差异。在有或无既往卒中及高血压分类的亚组中,比值比略有不同。

讨论

证实替罗非班在尿激酶溶栓后接受替罗非班治疗的AIS患者中可能是安全的,并且可以改善短期神经功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ceb/11922701/9aa978b2da66/fneur-16-1529331-g001.jpg

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