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替罗非班序贯双抗治疗急性非房颤醒后缺血性脑卒中的临床效果 被引量:4

Clinical effect of tirofiban sequential dual antiplatelet in treatment of acute wake-up ischemic stroke of patients without atrial fibrillation
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摘要 目的探讨替罗非班序贯阿司匹林联合氯吡格雷在治疗急性非房颤醒后缺血性脑卒中(WUIS)患者中的有效性和安全性。方法选取该院2020年3月至2021年12月急性非房颤WUIS患者90例,随机分为替罗非班序贯治疗组(治疗组)和双抗(阿司匹林和氯吡格雷)治疗组(对照组),各45例。治疗组患者先给予替罗非班治疗48 h,之后换用阿司匹林100 mg联合氯吡格雷75 mg序贯治疗19 d,最后改单抗(阿司匹林或氯吡格雷)治疗;对照组患者入组后接受阿司匹林100 mg联合氯吡格雷75 mg治疗21 d,之后改单抗治疗。比较治疗组和对照组患者神经功能缺损恢复情况和2组临床疗效及不良反应发生情况。结果治疗组患者在治疗后7、14、30 d,美国国立卫生院卒中量表(NIHSS)评分明显低于对照组(P<0.05);治疗后90 d的改良Rankin量表(mRS)评分明显低于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率为77.78%,对照组为57.78%,2组比较差异有统计学意义(P<0.05)。2组患者在试验期间出血等不良反应发生率差异无统计学意义(P>0.05)。结论替罗非班联合双抗(阿司匹林和氯吡格雷)能够降低急性非房颤WUIS患者神经功能缺损程度和致残率,且不增加不良反应。 Objective To investigate the effectiveness and safety of tirofiban sequential dual antiplatelet in-treatmentt of acute wake-up ischemic stroke(WUIS)of the patients without atrial fibrillation.Methods A total of 90 cases of atrial fibrillation WUIS in this hospital from March 2020 to December 2021 were selected and randomly divided into the tirofiban group(treatment group)and dual antiplatelet treatment group(aspirin combined with clopidogrel,control group),45 cases in each group.The treatment group was treated with tirofiban for 48 h bridging aspirin,then changed to the sequential treatment of 100 mg aspirin combined with 75 mg of clopidogrel for 19 d and finally changed to monoclonal antibody treatment(aspirin or clopidogrel).The control group received the treatment of 100 mg of aspirin combined with 25 mg of clopidogrel for 21 d,then changed to monoclonal antibody treatment.After treatment,the recovery situation of neurologic impairment,clinical effects and adverse reactions occurrence were compared between the two groups.Results The NIHSS scores on 7,14 and 30 d after treatment in the treatment group were significantly lower than those in the control group(P<0.05);the mRS scores on 90 d after treatment in the treatment group were significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The total effective rate of the treatment group was 77.78%,which was significantly higher than 57.78%in the control group,and the difference was statistically significant(P<0.05).The occurrence rate of adverse reactions such as hemorrhage had no statistical difference between the two groups(P>0.05).Conclusion Tirofiban combined with dual antiplatelet(aspirin and clopidogrel)could decrease the degree of neurological deficit and disability rate without increasing the adverse reactions in the patients without atrial fibrillation WUIS.
作者 周长青 韩裕富 高唱 ZHOU Changqing;HAN Yufu;GAO Chang(Department of Neurology,Affiliated Bishan Hospital of Chongqing Medical University,Chongqing 402760,China)
出处 《重庆医学》 CAS 2022年第22期3899-3902,共4页 Chongqing medicine
基金 重庆市璧山区科技局计划项目(Bskj2020017)。
关键词 醒后脑卒中 非房颤 缺血性脑卒中 替罗非班 双抗 wake-up ischemic stroke without atrial fibrillation tirofiban dual antiplatelet
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