Effect of Tirofiban on ACI Stent Thrombectomy and CT Perfusion Imaging in Cerebral Perfusion Abnormal Area

doi:10.7517/issn.1674-0475.220319

Abstract

Abstract: This study observed the effect of tirofiban on the antiplatelet function and CT perfusion imaging (CTPI) results of patients with acute cerebral infarction (ACI) stent thrombus removal. 100 patients with ACI were randomly divided into two groups according to the admission order. The control group was treated with stent thrombectomy, and the observation group was treated with tirofiban combined with stent thrombectomy. Compared the vascular recanalization and adverse events between the two groups. The changes of CTPI results, apoptotic molecules[Caspase-3, apoptotic protein (Bax)] and platelet function indexes (platelet adhesion rate and platelet aggregation rate) were detected. There were 40 cases in the observation group with TICI grades 2b and 3, and the vascular recanalization rate was 80.00%, while in the control group, there were 31 cases in the TICI grades 2b and 3 (the vascular recanalization rate was 62.00%). The vascular recanalization rate was higher than in the control group (P<0.05). Compared with pre-therapy the relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) in cerebral perfusion abnormal areas in the two groups were both increased (P<0.05), while the relative mean transmit time (rMTT) and relative time to peak (rTTP) were both decreased. After treatment, rCBF and rCBV in cerebral perfusion abnormal areas in the observation group were higher than those in the control group, and rMTT and rTTP were lower than those in the control group (P<0.05). The Caspase-3, Bax, platelet adhesion rate and platelet aggregation rate in the two groups were decreased than those before treatment in the same group (P<0.05). After treatment, the apoptosis molecules and platelet function indexes in the observation group were lower than those in the control group (P<0.05). The incidence of adverse events in the observation group was 4.00%, which was lower than 16.00% in the control group (P<0.05). Tirofiban can improve the cerebral hemodynamics in the cerebral perfusion abnormal area of patients with ACI stent thrombectomy with good antiplatelet function and low incidence of adverse events.

Key words: tirofiban, acute cerebral infarction, stent thrombectomy, antiplatelet function, CT perfusion imaging

WANG Zheng, JIANG Hongmei. Effect of Tirofiban on ACI Stent Thrombectomy and CT Perfusion Imaging in Cerebral Perfusion Abnormal Area[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1072-1076.

References

[1] 魏铭, 黄楹. 急性缺血性卒中血管内治疗影像筛选研究进展[J]. 国际神经病学神经外科学杂志, 2020, 47(1):95-98.
[2] 查明明, 李芸, 吴敏, 等. 首选血管内治疗方式对急性椎基底动脉闭塞患者临床结局的影响[J]. 中华内科杂志, 2021, 60(11):970-976.
[3] 王彦平, 温昌明, 张保朝, 等. TREVO支架取栓联合替罗非班在急性前循环大血管闭塞患者中的应用分析[J]. 中华神经医学杂志, 2021, 20(1):29-34.
[4] 董强, 吴笃初, 吕传真. 神经功能缺损评分的比较研究:193例资料分析[J]. 中国临床神经科学, 2000, 8(3):189-191.
[5] 马玉栋. 急性重型缺血性卒中的病因、血管内治疗及中期预后分析[D]. 天津:南开大学, 2014.
[6] Debeaumarche H, Din A A E, Thouant P, et al. Progression in cerebral microbleeds number after acute myocardial infarction:Harmful role of triple antithrombotic therapy[J].Archives of Cardiovascular Diseases Supplements, 2020, 12(1):5-6.
[7] Sasaki T, Yasuda T, Abe D, et al. A case of multiple cerebral infarction preceding acute exacerbation of idiopathic thrombocytopenic purpura[J]. Journal of Stroke and Cerebrovascular Diseases, 2019, 28(3):789-791.
[8] 苏旭东, 姚冬静, 刘增品, 等. 替罗非班动静脉联合序贯治疗大脑中动脉支架内急性血栓形成效果观察[J]. 介入放射学杂志, 2021, 30(1):5-8.
[9] 张利军, 惠鑫, 刘基, 等. 替罗非班治疗急性缺血性卒中安全性及有效性的Meta分析[J]. 中风与神经疾病杂志, 2020, 37(7):594-599.
[10] 赵宏峰, 徐晶, 熊莉君, 等. 机械取栓联合低剂量替罗非班治疗急性前循环脑梗死的效果分析[J]. 重庆医学, 2020, 49(3):430-434.
[11] 郝建强, 谢飞, 刘欢, 等. 颅内动脉瘤支架置入术后发生盐酸替罗非班相关血小板减少症的危险因素分析[J]. 临床神经病学杂志, 2021, 34(2):86-90.
[12] 吴桥伟, 李立, 邵秋季, 等. 替罗非班在血流导向装置治疗颅内未破裂动脉瘤术中的预防性应用研究[J]. 中华神经外科杂志, 2021, 37(4):342-347.
[13] 吕洋, 郝立鹏, 袁超, 等. 替罗非班治疗阿替普酶静脉溶栓后再闭塞脑梗死患者的有效性和安全性分析[J]. 中华神经医学杂志, 2021, 20(4):350-355.
[14] 李永, 刘彬, 王荣. 替罗非班对急性脑梗死患者炎性因子及免疫功能的影响研究[J]. 重庆医学, 2021, 50(4):630-633.
[15] 付春丽, 王孟坤, 王俊海. 替罗非班治疗高复发风险短暂性脑缺血发作疗效分析[J]. 中风与神经疾病杂志, 2021, 38(6):488-491.