替罗非班在急性颅内大血管闭塞血管内治疗中应用的安全性分析

Safety of tirofiban in endovascular reperfusion therapy for acute ischemic stroke due to large artery occlusion

目的探讨颅内大血管闭塞性缺血性脑卒中行血管内再通治疗术中合并使用替罗非班对颅内出血的影响。方法回顾性分析本中心接受血管内再通治疗的急性颅内大血管闭塞性缺血性卒中患者的临床资料,比较术中使用替罗非班与未使用替罗非班两组患者的一般临床特点、治疗方式以及颅内出血并发症等差异。结果共计纳入173例患者接受血管内再通治疗,其中替罗非班组87例,非替罗非班组86例,替罗非班组中后循环(39.08%vs 25.58%,P=0.034)、糖尿病(24.14%vs 10.47%,P=0.026)比例显著高于非替罗非班组,非替罗非班组中房颤患者比例显著高于替罗非班组(P<0.001),两组患者手术再通率及随访90 d预后良好比例相当,围手术期颅内出血并发症未见差异。结论血管内再通治疗合并使用替罗非班是相对安全的,并未增加出血风险。

Objective To investigate the relationship between intracranial bleeding complications after mechanical thrombectomy with or without tirofiban treatment.Methods Retrospective analysis on 173 patients with acute ischemic stroke due to large artery occlusion underwent endovascular treatment in our center were reviewed..The baseline characteristics,ways and the efficacy of endovascular treatment,intracranial bleeding complications of two groups were retrospectively analyzed.Results 173 patients received endovascular treatment were categorized to tirofiban group(n=87)and no tirofiban group(n=86).Prevalence of diabetes(24.14%vs 10.47%,P=0.026)and posterior circulation in tirofiban group were higher than those in the no tirofiban group.The prevalence of atrial fibrillation was significantly higher in the no tirofiban group than that in the tirofiban group(P<0.001).The rate of final recanalization and good clinical outcome were comparable between the two groups.There were no differences in intracranial bleeding complications between the two groups.Conclusions Conjunctive use of tirofiban didn’t increase the risk of intracranial bleeding complications during the endovascular reperfusion therapy.