替罗非班联合机械取栓治疗急性缺血性卒中的研究进展 Research Progress of Tirofiban Combined with Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke

摘要： 急性缺血性卒中大血管闭塞患者在有效时间内经机械取栓治疗可改善血流动力学状态及临床症状，但机械取栓常合并血管再闭塞，影响患者预后。血小板糖蛋白Ⅱb/Ⅲa（platelet glycoprotein Ⅱb/Ⅲa，GP Ⅱb/Ⅲa）受体拮抗剂通过抑制血小板聚集过程的最后共同通路防止血管再闭塞。目前，在缺血性卒中机械取栓治疗的围手术期，辅以GP Ⅱb/Ⅲa受体拮抗剂治疗对临床结局的影响尚存争议。本文对GP Ⅱb/Ⅲa受体拮抗剂替罗非班对急性缺血性卒中机械取栓后血管再闭塞的疗效及安全性进行综述，发现替罗非班联合机械取栓治疗急性缺血性卒中是安全的，但有效性尚需要规范的临床研究证据证实。 Abstract: In acute ischemic stroke patients with large vessel occlusion, mechanical thrombectomy can improve the hemodynamic status and clinical symptoms within the effective time, but mechanical thrombectomy is often associated with vascular re-occlusion, which affects the prognosis of patients. Platelet glycoprotein Ⅱb/Ⅲa (GP Ⅱb/Ⅲa) receptor antagonists prevent vascular re-occlusion by inhibiting the last common pathway of platelet aggregation. At present, the effects of GP Ⅱb/Ⅲa receptor antagonists on the clinical outcome during the perioperative period of mechanical thrombectomy in ischemic stroke remain controversial. This paper reviewd the efficacy and safety of tirofiban, a GP Ⅱb/Ⅲa receptor antagonist, in the treatment of vascular re-occlusion after mechanical thrombectomy in acute ischemic stroke. It was found that tirofiban combined with mechanical thrombectomy was safe for the treatment of acute ischemic stroke, but its therapeutic effectiveness still needs to be confirmed by standardized clinical research evidence.