Xue Yao, Chai Yumei
Department of Neurology, The First Hospital of Yulin No. 93 Yuxi Avenue, Yuyang District, Yulin 719000, Shaanxi, China.
Am J Transl Res. 2025 Mar 15;17(3):2044-2056. doi: 10.62347/BGRM4102. eCollection 2025.
To evaluate the efficacy and safety of arterial tirofiban injection in patients with acute ischemic stroke (AIS) beyond the thrombolysis time window.
In this retrospective single-center study, clinical data were analyzed from 230 AIS patients treated at the First Hospital of Yulin between July 2021 and January 2023. Patients were divided into two groups: the observation group (n=102) treated with tirofiban combined with dual antiplatelet therapy, and the control group (n=128) that received dual antiplatelet therapy alone. Post-treatment follow-up evaluated neurological function, endothelial function, and safety using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI). Endothelial function was assessed by measuring levels of endothelin-1 (ET-1), nitric oxide (NO), and von Willebrand factor (vWF). Baseline characteristics, treatment protocols, and complications were analyzed to ensure the reliability and scientific rigor of the results.
Compared to the control group, the observation group demonstrated significant improvements in NIHSS, mRS, and BI scores, indicating enhanced neurological function and self-care ability. Endothelial markers (ET-1, NO, and vWF) also significantly improved in the observation group, suggesting a beneficial effect on endothelial function. The overall efficacy rate at 90 days was 86.72% in the observation group, significantly higher than the 74.50% in the control group (P<0.05). In terms of safety, there were no significant differences in the incidence of adverse events between the two groups, indicating that tirofiban is well-tolerated. Multivariate analysis identified age, treatment protocol, and baseline NO levels as independent factors affecting the 90-day prognosis, underscoring the importance of individualized treatment strategies for AIS patients.
Arterial injection of tirofiban significantly improves neurological and endothelial function in AIS patients beyond the thrombolysis time window while maintaining a favorable safety profile. These findings support the use of tirofiban in patients who are ineligible for intravenous thrombolysis or endovascular treatment.
评估动脉注射替罗非班对处于溶栓时间窗之外的急性缺血性卒中（AIS）患者的疗效和安全性。
在这项回顾性单中心研究中，分析了2021年7月至2023年1月在榆林市第一医院接受治疗的230例AIS患者的临床资料。患者分为两组：观察组（n = 102）接受替罗非班联合双联抗血小板治疗，对照组（n = 128）仅接受双联抗血小板治疗。治疗后随访使用美国国立卫生研究院卒中量表（NIHSS）、改良Rankin量表（mRS）和Barthel指数（BI）评估神经功能、内皮功能和安全性。通过测量内皮素-1（ET-1）、一氧化氮（NO）和血管性血友病因子（vWF）水平评估内皮功能。分析基线特征、治疗方案和并发症，以确保结果的可靠性和科学严谨性。
与对照组相比，观察组的NIHSS、mRS和BI评分有显著改善，表明神经功能和自理能力增强。观察组的内皮标志物（ET-1、NO和vWF）也有显著改善，表明对内皮功能有有益影响。观察组90天的总有效率为86.72%，显著高于对照组的74.50%（P<0.05）。在安全性方面，两组不良事件发生率无显著差异，表明替罗非班耐受性良好。多因素分析确定年龄、治疗方案和基线NO水平为影响90天预后的独立因素，强调了AIS患者个体化治疗策略的重要性。
动脉注射替罗非班可显著改善处于溶栓时间窗之外的AIS患者的神经和内皮功能，同时保持良好的安全性。这些发现支持在不符合静脉溶栓或血管内治疗条件的患者中使用替罗非班。
