替罗非班可减少脑梗死静脉溶栓后进展性脑梗死的发生率

彭伟.替罗非班可减少脑梗死静脉溶栓后进展性脑梗死的发生率[J].内科急危重症杂志,2023,29(2):137-140

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DOI：10.11768/nkjwzzzz20230210

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作者	单位	E-mail
彭伟	淮南新华医疗集团新华医院肾内科	HBSZqiao@126.com

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中文摘要:

目的：探讨脑梗死静脉溶栓后早期使用替罗非班是否可减少进展性脑梗死的发生率。方法：选择140例脑梗死溶栓后低出血风险的患者，采用回顾性队列研究方法，51例静脉溶栓后使用替罗非班为暴露组，89例静脉溶栓后未使用替罗非班为非暴露组。比较2组进展性脑梗死发生率、早期症状改善率、症状性脑出血发生率及发病90d预后的差异。结果：暴露组进展性脑梗死发生率显著低于非暴露组（P=0.011），早期症状改善率明显高于非暴露组（P<0.001），2组患者出血转化率比较，差异无统计学意义（P=0.300），暴露组90d预后显著好于非暴露组（P=0.037）。结论：对于溶栓后低出血风险脑梗死患者，使用替罗非班可减少进展性脑梗死的发生率，能促进早期症状恢复并改善长期预后，不增加症状性脑出血发生率。

英文摘要:

Objective: To explore whether the early use of tirofiban after intravenous thrombolysis can reduce the incidence of progressive cerebral infarction. Methods: A total of 140 patients with low risk of hemorrhage after thrombolysis for cerebral infarction were enrolled. A retrospective cohort study was conducted. A total of 51 patients given tirofiban after intravenous thrombolysis served as the exposed group, and 89 patients not given tirofiban after intravenous thrombolysis served as the non-exposed group. The incidence of progressive cerebral infarction, early symptom improvement, symptomatic intracerebral hemorrhage and 90-day prognosis were compared between the two groups. Results: The incidence of progressive cerebral infarction was significantly lower in the exposed group than in the non-exposed group(P=0.011). Early symptom improvement rate was significantly higher in the exposed group than in the non-exposed group(P< 0.001). There was no significant difference in the bleeding conversion rate between the two groups (P=0.300). The 90-day prognosis of the exposed group was significantly better than that of the non-exposed group(P= 0.037). Conclusion: For cerebral infarction patients with low risk of hemorrhage after thrombolysis, the use of tirofiban after intravenous thrombolysis can reduce the incidence of progressive cerebral infarction, promote the recovery of early symptoms and improve the long-term prognosis without increasing the incidence of symptomatic cerebral hemorrhage.