Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofib...Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.展开更多
Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with A...Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital,of which were computer-randomized into a control group(20 cases,with regular urokinase intravenous thrombolysis therapy)and a research group(20 cases,combined with early Tirofiban treatment)from January 2018 to December 2022.The intervention outcomes between these two groups were compared and analyzed.Result:The blood platelet-related parameters before treatment had no statistical difference between the two groups(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).The Barthel index before treatment in both groups had no statistical difference(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).Conclusion:Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters,hence improving treatment benefits and living capacity for patients,with definite clinical benefits.展开更多
目的比较阿加曲班联合阿司匹林与替罗非班治疗进展性脑梗死的疗效和安全性。方法收集2021年6月—2023年10月在南方医院增城院区住院诊治的进展性脑梗死患者101例,将收集的病例患者分为两组,A组(n=64)应用阿加曲班+阿司匹林治疗,B组(n=37...目的比较阿加曲班联合阿司匹林与替罗非班治疗进展性脑梗死的疗效和安全性。方法收集2021年6月—2023年10月在南方医院增城院区住院诊治的进展性脑梗死患者101例,将收集的病例患者分为两组,A组(n=64)应用阿加曲班+阿司匹林治疗,B组(n=37)应用替罗非班治疗,记录两组患者治疗前后美国国立卫生研究院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、改良Rankin量表(modified Rankin Scale,mRS)评分及巴氏指数评定量表(Barthel Index,BI)来评估患者在不同时间段的治疗效果,同时记录治疗过程中各种出血并发症来评估用药安全性。结果在治疗大动脉粥样硬化型进展性脑梗死患者中,A组治疗后48 h、7 d、出院时NIHSS、30 d、90 d mRS较B组均有下降(P<0.05),治疗后30 d、90 d BI较B组升高(P<0.05);在治疗小血管闭塞型进展性脑梗死患者中,两组用药差异无统计学意义(P>0.05);在治疗后循环进展性脑梗死患者中,A组出院时NHISS评分低于B组(P<0.05);两组治疗后30 d、90 d mRS评分均有下降(P>0.05),治疗后30 d BI指数、90 d BI指数均有上升(P>0.05);两组用药治疗前循环进展性脑梗死差异无统计学意义(P>0.05);两组用药治疗过程中均无严重不良反应(P>0.05)。结论阿加曲班联合阿司匹林治疗大动脉粥样硬化型进展性脑梗死较替罗非班组效果好,两组治疗小血管闭塞性进展性脑梗死疗效相当;阿加曲班联合阿司匹林治疗后循环进展性脑梗死早期效果较替罗非班可能更好,两组治疗前循环进展性脑梗死效果相当;两组用药安全性相当,未发生严重的出血不良事件。展开更多
目的:观察替罗非班对急性前循环大血管闭塞性脑梗死(acute large vessel occlusion stroke,ALVOS)静脉溶栓(intravenous thrombolysis,IVT)桥接血管内治疗(endovascular therapy,EVT)患者预后的影响。方法:选取2021年1月—2023年1月宜...目的:观察替罗非班对急性前循环大血管闭塞性脑梗死(acute large vessel occlusion stroke,ALVOS)静脉溶栓(intravenous thrombolysis,IVT)桥接血管内治疗(endovascular therapy,EVT)患者预后的影响。方法:选取2021年1月—2023年1月宜都市人民医院收治的73例ALVOS患者作为研究对象,根据随机数表法将患者分为对照组36例和研究组37例。对照组采用IVT桥接EVT治疗,研究组在此基础上加用替罗非班治疗,比较两组取栓次数及血管再通率、美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、改良Rankin量表(modified Rankin scale,mRS)评分、神经功能血清学指标[神经生长因子(nerve growth factor,NGF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、中枢神经特异性蛋白(central nervous system specific protein β,S100β)]、凝血功能[凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、D-二聚体(D-dimer,D-D)]及安全性。结果:研究组取栓次数少于对照组,差异有统计学意义(P<0.05);两组血管再通率比较,差异无统计学意义(P>0.05)。研究组治疗后NIHSS评分、mRS评分及S100β、D-D水平低于对照组,NGF、BDNF水平高于对照组,PT、APTT长于对照组,差异有统计学意义(P<0.05);两组症状性颅内出血率、各种类型出血率、复发率、病死率比较,差异无统计学意义(P>0.05)。结论:在IVT桥接EVT治疗过程中加用替罗非班可改善ALVOS患者的神经功能状态及凝血功能水平,短期预后较好。展开更多
基金supported by the Natural Science Foundation of Inner Mongolia(No.2021MS08169)the Medical and health Science and Technology Project of Inner Mongolia(No.202201571).
文摘Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.
文摘Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with urokinase.Method:The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital,of which were computer-randomized into a control group(20 cases,with regular urokinase intravenous thrombolysis therapy)and a research group(20 cases,combined with early Tirofiban treatment)from January 2018 to December 2022.The intervention outcomes between these two groups were compared and analyzed.Result:The blood platelet-related parameters before treatment had no statistical difference between the two groups(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).The Barthel index before treatment in both groups had no statistical difference(P>0.05),but the research group was higher than that of the control group after treatment(P<0.05).Conclusion:Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters,hence improving treatment benefits and living capacity for patients,with definite clinical benefits.
文摘目的比较阿加曲班联合阿司匹林与替罗非班治疗进展性脑梗死的疗效和安全性。方法收集2021年6月—2023年10月在南方医院增城院区住院诊治的进展性脑梗死患者101例,将收集的病例患者分为两组,A组(n=64)应用阿加曲班+阿司匹林治疗,B组(n=37)应用替罗非班治疗,记录两组患者治疗前后美国国立卫生研究院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、改良Rankin量表(modified Rankin Scale,mRS)评分及巴氏指数评定量表(Barthel Index,BI)来评估患者在不同时间段的治疗效果,同时记录治疗过程中各种出血并发症来评估用药安全性。结果在治疗大动脉粥样硬化型进展性脑梗死患者中,A组治疗后48 h、7 d、出院时NIHSS、30 d、90 d mRS较B组均有下降(P<0.05),治疗后30 d、90 d BI较B组升高(P<0.05);在治疗小血管闭塞型进展性脑梗死患者中,两组用药差异无统计学意义(P>0.05);在治疗后循环进展性脑梗死患者中,A组出院时NHISS评分低于B组(P<0.05);两组治疗后30 d、90 d mRS评分均有下降(P>0.05),治疗后30 d BI指数、90 d BI指数均有上升(P>0.05);两组用药治疗前循环进展性脑梗死差异无统计学意义(P>0.05);两组用药治疗过程中均无严重不良反应(P>0.05)。结论阿加曲班联合阿司匹林治疗大动脉粥样硬化型进展性脑梗死较替罗非班组效果好,两组治疗小血管闭塞性进展性脑梗死疗效相当;阿加曲班联合阿司匹林治疗后循环进展性脑梗死早期效果较替罗非班可能更好,两组治疗前循环进展性脑梗死效果相当;两组用药安全性相当,未发生严重的出血不良事件。
文摘目的:观察替罗非班对急性前循环大血管闭塞性脑梗死(acute large vessel occlusion stroke,ALVOS)静脉溶栓(intravenous thrombolysis,IVT)桥接血管内治疗(endovascular therapy,EVT)患者预后的影响。方法:选取2021年1月—2023年1月宜都市人民医院收治的73例ALVOS患者作为研究对象,根据随机数表法将患者分为对照组36例和研究组37例。对照组采用IVT桥接EVT治疗,研究组在此基础上加用替罗非班治疗,比较两组取栓次数及血管再通率、美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、改良Rankin量表(modified Rankin scale,mRS)评分、神经功能血清学指标[神经生长因子(nerve growth factor,NGF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、中枢神经特异性蛋白(central nervous system specific protein β,S100β)]、凝血功能[凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、D-二聚体(D-dimer,D-D)]及安全性。结果:研究组取栓次数少于对照组,差异有统计学意义(P<0.05);两组血管再通率比较,差异无统计学意义(P>0.05)。研究组治疗后NIHSS评分、mRS评分及S100β、D-D水平低于对照组,NGF、BDNF水平高于对照组,PT、APTT长于对照组,差异有统计学意义(P<0.05);两组症状性颅内出血率、各种类型出血率、复发率、病死率比较,差异无统计学意义(P>0.05)。结论:在IVT桥接EVT治疗过程中加用替罗非班可改善ALVOS患者的神经功能状态及凝血功能水平,短期预后较好。
