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

目的分析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。方法选择2016年2月至2020年1月在我院行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102例患者为病例组,以性别、年龄(±5)进行1∶1配对选择同期行颅内动脉瘤支架置入术后未发生盐酸替罗非班相关血小板减少症的102例患者为对照组进行回顾性分析。收集可能影响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影响因素,在单因素分析基础上行多因素Logistic回归分析。结果单因素基础上多因素分析结果显示:动脉瘤直径≥5 mm(OR=2.106,95%CI:1.573~2.782)、部分栓塞(OR=1.830,95%CI:1.382~2.431)、多发颅内动脉瘤(OR=2.902,95%CI:2.117~3.328)、有吸烟史(OR=2.084,95%CI:1.625~2.813)、术前血小板计数<130×10⁹/L(OR=2.254,95%CI:1.718~2.911)、肌酐高于正常范围(OR=2.790,95%CI:2.016~3.255)、联合使用抗菌药物(OR=2.095,95%CI:1.647~2.811)为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。结论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主要受动脉瘤直径、栓塞程度、动脉瘤数量、吸烟史、术前血小板计数、肌酐及联合使用抗菌药物的影响,临床上可通过控制上述因素以降低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风险。

Analysis of risk factors for tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stent placement

Objective To analyze the risk factors of tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stenting.Methods One hundred and two patients with tirofiban associated thrombocytopenia after intracranial aneurysm stent implantation in our hospital from February 2016 to January 2020 were selected as the case group,and 102 patients without tirofiban associated thrombocytopenia after intracranial aneurysm stent implantation were selected as the control group according to gender and age(±5)analysis.Collect the factors that may affect the occurrence of tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stent placement,and perform multivariate Logistic regression analysis on the basis of univariate analysis.Results The results of multivariate analysis on a single factor basis showed that the diameter of aneurysm≥5 mm(OR=2.106,95%CI:1.573-2.782),partial embolization(OR=1.830,95%CI:1.382-2.431),multiple intracranial aneurysms(OR=2.902,95%CI:2.117-3.328),no history of smoking(OR=2.084,95%CI:1.625-2.813),preoperative platelet count<130×10⁹/L(OR=2.254,95%CI:1.718-2.911),creatinine higher than normal range(OR=2.790,95%CI:2.016-3.255),combined use of antibacterial drugs(OR=2.095,95%CI:1.647-2.811)were risk factors for tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stent placement.Conclusions Tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stent placement is mainly affected by the diameter of the aneurysm,the degree of embolization,the number of aneurysms,the history of smoking,preoperative platelet count,creatinine and combined use of antibacterial drugs.In clinical practice,the above factors can be controlled to reduce the risk of tirofiban hydrochloride-related thrombocytopenia after intracranial aneurysm stent placement.