依替巴肽注射液在急性缺血性脑血管病中的应用

Application of eptifibatide injection in acute ischemic cerebrovascular disease

目的探讨依替巴肽注射液治疗急性缺血性脑血管病(ICVD)的效果及安全性。方法回顾性分析34例接受依替巴肽注射液治疗的ICVD患者资料,检测患者治疗前后的血液流变学、凝血功能、血脂等指标;构建累计注射量与各指标的量效关系,通过正常指标值预测其有效累计剂量。比较治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及数字减影血管造影术(DSA)检查结果,观察其有效性和安全性。结果治疗后患者的血液流变学、凝血功能、血脂等指标均出现不同程度的改善(P均<0.05)。血液流变学指标均能被模拟成一元二次方程,R^(2)均大于0.95;在凝血指标模拟中,除依替巴肽用量对凝血酶时间影响较小、无法被模拟出相应方程外,其余均能被模拟出一元二次方程,且R^(2)均大于0.95。所有患者治疗后均未出现症状性颅内出血等严重不良事件。患者治疗1周后NIHSS评分降低(P<0.05)。结论急性ICVD患者接受依替巴肽注射液强化抗血小板聚集治疗安全且有效。

Objective To evaluate the treatment effectiveness and safety of eptifibatide injection in the treatment of acute ischemic cerebrovascular disease(ICVD).Methods Clinical data of 34 ICVD patients treated with eptifibatide injection were retrospectively analyzed.The indexes of blood rheology,blood coagulation and blood lipid before and after treatment were detected.The dose-effect relationship between the cumulative injection dose and each index was established,and the effective cumulative dose was predicted by the normal index values.The effectiveness were verified by comparing National Institute of Health Stroke Scale(NIHSS)and digital subtraction angiography(DSA)score before and after treatment,and the safety were evaluated after treatment.Results The indexes of blood rheology,blood coagulation and blood lipid were improved to different degree before and after treatment,and the differences were statistically significant(all P<0.05).The blood rheology index could be simulated as a quadratic equation of one variable,and R^(2) was greater than 0.95;in the simulation of blood coagulation indexes,the amount of eptifibatide exerted mild effect on thrombin time.Hence,the corresponding equation could not be simulated,and the remaining indexes could be simulated with a quadratic equation with one variable,and all R^(2) were greater than 0.95.All patients did not develop symptomatic intracranial hemorrhage after administration.The scores of NIHSS were significantly decreased after one week of treatment(P<0.05).Conclusion It is safe and effective to strengthen the anti-platelet aggregation therapy with eptifibatide injection in ICVD patients.