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

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [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=38, 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=27, 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=21, 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=68, 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=)]
    2018-08-05 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=38, 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=27, 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=21, 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=68, 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
  3. [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=38, 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=27, 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=21, 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=68, 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=)]
  4. [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=38, 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=27, 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=21, 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=68, 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=)]
  5. [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=38, 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=27, 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=21, 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=68, 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=)]
    2017-11-11 1e0f8808m18(暂无匿称)

    好文章.学习了.

    0

相关资讯

Heart:STEMI患者长期死亡率和院前替罗非班治疗!

由此可见,在STEMI患者中,基线血浆NT-proBNP水平可独立预测长期死亡率。基线NT-proBNP水平高于中位数的患者,采用替罗非班早期院前治疗可以显著降低30天和1年死亡率,提示高危患者可能获得特别的好处,这一发现应该在其他研究中予以证实。

Stroke:血管内卒中治疗合用替罗非班增加脑出血风险

使用IIb/IIIa抑制剂替罗非班与严重出血并发症和机械性取栓后转归的相关性尚不清楚。为此,德国Heidelberg大学神经科的Lars Kellert博士等人进行了一项研究,研究结果在线发表在2013年3 月5日的Stroke杂志上。研究结果显示:血管内卒中治疗,联合使用糖蛋白IIb-IIIa抑制剂替罗非班与致死性颅内出血风险增加及转归差相关。研究中纳入了前瞻性收集的连续病例,这些病例是在200

替罗非班在冠状动脉粥样硬化性心脏病治疗的中国专家共识

血小板活化和聚集在动脉粥样硬化血栓形成的发病机制中起着关键作用,也是导致急性冠状动脉(冠脉)综合征(ACS)的直接原因。因此,抗血小板治疗贯穿冠 心病治疗始终。目前,临床常用口服抗血小板药物均是在上游抑制血小板活化,而血小板膜蛋白(GP)Ⅱb/Ⅲa抑制剂(GPI)作用在血小板聚集的最后环 节,是最强的抗血小板药物。作为一种非肽类小分子GPI,替罗非班在ACS及经皮冠脉介入治疗(PCI)的患者中