尿激酶联合替罗非班治疗基底动脉闭塞再通二例

Two cases of the recanalization of basilar artery occlusion with the therapy of urokinase and tirofiban

目的报道2例基底动脉闭塞的患者,临床联合应用替罗非班后再通的临床资料,探讨替罗非班对脑血管闭塞后再通的机制。方法 2例基底动脉闭塞的患者均以后循环缺血为临床表现而就诊,患者病情渐进发展,均出现意识障碍。经全脑血管造影检查证实为基底动脉闭塞,单纯应用尿激酶溶栓后症状无明显好转,联合应用替罗非班后,患者症状5min后迅速恢复,预后良好。结果例1 NIHSS评分从13分降到2分,例2 NIHSS评分从7分降到0分,两例患者复查MRA可见基底动脉显影良好。结论尿激酶联合替罗非班初步证实可应用于基底动脉闭塞后的再通。

Objective To report the clinical information of 2 cases of basilar artery occlusion whose conditions were treated by the application of tirofiban; and further analyze the mechanism and application of tirofican on this medical condition. Method 2 patients were hospitalized for basilar artery occlusion with the symptoms of posterior circulation ischemia. They then both had consciousness disturbances and basilar artery occlusions were confirmed. There was no distinguishable improvement in their conditions with the application of urokinase thrombolytic therapy. However, both patients were recovering after the combined use of Tirofiban in 5 minutes and showed satisfying prognosis. Results The NIHSS index of the first patient dropped from 13 points to 2 points while it dropped from 7 points to zero with the second patient. The following magnetic resonance angiography （ MRA ） for both patients showed nearly no basilar artery occlusion. Conclusion Urokinase combined with tirofiban had confirmed that can be applied to recanalization of basilar artery occlusion.