替罗非班对静脉溶栓后早期神经功能恶化的预防和治疗研究进展

Research progress on the prevention and treatment of early neurological deterioration after intravenous thrombolysis with tirofiban

目前对于发病时间在4.5 h内的急性缺血性脑卒中患者,静脉溶栓是早期再灌注的首选方法,但溶栓后24 h内易发生早期神经功能恶化,主要与缺血进展有关,提前应用抗血小板药物可能会预防或改善早期神经恶化。但传统抗血小板药物起效慢,且相关研究证实有出血风险,建议24 h后应用,但溶栓后24 h又是神经功能恶化的高发期,故需找到一种24 h内可以应用的抗血小板药物。已有部分研究发现静脉溶栓后早期应用替罗非班可预防早期神经功能恶化的出现,同时,对于已出现早期神经功能恶化的患者,应用替罗非班,可有效改善患者远期预后。本文将对替罗非班应用于静脉溶栓后早期神经功能恶化的预防和治疗的相关研究进展进行阐述。

At present,for acute ischemic stroke patients with onset time within 4.5 hours,intravenous thrombolysis is the preferred method for early reperfusion,but early neurological deterioration is prone to occur within 24 hours after thrombolysis,which is mainly related to the progress of ischemia.Early use of antiplatelet drugs may prevent or improve early neurological deterioration,but traditional antiplatelet drugs have a slow effect and related studies have shown a risk of bleeding.It is recommended to apply after 24 hours.However,24 hours after thrombolysis is a high-risk period for neu-rological deterioration,so it is necessary to find an antiplatelet drug that can be applied within 24 hours.Some studies have found that early use of tirofiban after intravenous thrombolysis can prevent early neurological deterioration.At the same time,for patients who have already experienced earlyneurological deterioration,the use of tirofiban can effectively improve their long-term prognosis.This article will elaborate on the research progress of the application of tirofiban in the prevention and treatment of early neurological deterioration after intravenous thrombolysis.