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Stroke:替罗非班提高了血管内取栓治疗的AIS患者功能预后!

2017-11-11 xing.T MedSci原创

在接受了ET治疗的AIS患者中,替罗非班与较高的sICH无关,这似乎导致了较低的死亡和更好的长期功能独立性几率。但是替罗非班预防早期再闭塞的疗效、潜在机制及其最佳治疗方案需要进一步的研究来予以确定。

大多经历急性缺血性卒中(AIS)的中国患者是大动脉硬化所致,而非心源性脑栓塞,以及这些接受血管血栓清除术(ET)的患者采用替罗非班联合治疗是否安全和有效仍是未知的。近日,卒中领域权威杂志Stroke上发表了一篇研究文章。该研究旨在评价中国进行ET治疗的AIS患者联合替罗非班治疗的安全性和有效性。

这项观察性研究是一项基于单中心的前瞻性登记研究,纳入了从2013年1月至2017年2月接受第二代支架ET或ET联合小剂量替罗非班治疗的AIS患者。该研究的主要终点是症状性脑出血(sICH)。次要终点包括早期再闭塞率、任何出血、致命性出血和3个月及长期预后。

该研究共纳入了一百八十例受试者,其中90例接受了替罗非班治疗,90例未接受替罗非班治疗。六十三例(35%)发生ICH,其中19例(11%)为sICH,9例(5%)为致命性ICH。接受了替罗非班治疗者中有十例(11%)患者经历了Sich,在未接受替罗非班治疗者中有9例(10%)患者经历了sICH,差异无显著性(P=0.808)。接受了替罗非班治疗的90例患者中有4例(4.4%)发生早期再闭塞事件,未接受替罗非班治疗的90例患者中有8例(8.9%)发生早期再闭塞事件(P=0.370)。一百六十一名(89%)受试者完成了长期随访,与非治疗组相比,替罗非班治疗的患者死亡率较低(分别为23% vs. 44%,P=0.005)。此外,替罗非班与更好的长期功能独立性相关(调整后的比值比为4.37,95%可信区间为1.13-16.97,P=0.033)。

在接受了ET治疗的AIS患者中,替罗非班与较高的sICH无关,这似乎导致了较低的死亡和更好的长期功能独立性几率。但是替罗非班预防早期再闭塞的疗效、潜在机制及其最佳治疗方案需要进一步的研究来予以确定。

原始出处:

Wenbo Zhao,et al. Low-Dose Tirofiban Improves Functional Outcome in Acute Ischemic Stroke Patients Treated With Endovascular Thrombectomy.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.117.019193

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    2018-08-05 zsyan
  2. [GetPortalCommentsPageByObjectIdResponse(id=1779632, encodeId=52291e79632e4, content=<a href='/topic/show?id=0cff2190ee' target=_blank style='color:#2F92EE;'>#AIS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2190, encryptionId=0cff2190ee, topicName=AIS患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dab8203, createdName=zsyan, createdTime=Sun Aug 05 10:05:00 CST 2018, time=2018-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1634936, encodeId=0333163493678, content=<a href='/topic/show?id=f8072189cf' target=_blank style='color:#2F92EE;'>#AIS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2189, encryptionId=f8072189cf, topicName=AIS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ef022348744, createdName=膀胱癌, createdTime=Sun Apr 01 00:05:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479052, encodeId=1dff14e90522d, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Mon Nov 13 02:05:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492848, encodeId=be271492848bd, content=<a href='/topic/show?id=447732948d0' target=_blank style='color:#2F92EE;'>#功能预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32948, encryptionId=447732948d0, topicName=功能预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=728c8977388, createdName=zsyan, createdTime=Mon Nov 13 02:05:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260526, encodeId=29e0260526c7, content=好文章.学习了., beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Nov 11 12:29:29 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2018-04-01 膀胱癌
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    2017-11-11 1e0f8808m18(暂无匿称)

    好文章.学习了.

    0

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