替罗非班治疗超时间窗急性后循环缺血性脑卒中患者的效果

Application effect of tirofiban in the treatment of acute posterior circulation stroke patients with over time window

目的观察替罗非班治疗超时间窗急性后循环缺血性脑卒中患者的效果。方法回顾性选取2020年12月—2022年6月于北京市昌平区医院诊治的超时间窗急性后循环缺血性脑卒中患者82例,根据治疗方法分为对照组(n=32)与观察组(n=50)。对照组患者采用常规治疗,观察组患者在常规治疗基础上予以替罗非班治疗。比较2组治疗前及治疗后7、14 d美国国立卫生研究院卒中量表(NIHSS)评分,治疗前及治疗后48 h凝血功能指标,治疗后14 d内出血事件发生率,治疗前及治疗后3、6个月Barthel指数。结果治疗后7、14 d,2组NIHSS评分均较治疗前明显降低,且观察组均低于对照组(P<0.01)。治疗后48 h,2组纤维蛋白原(Fib)水平低于治疗前,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)长于治疗前,且观察组Fib水平低于对照组,PT、APTT长于对照组(P<0.05)。2组治疗后14 d内出血事件发生率比较,差异无统计学意义(P>0.05)。治疗后3、6个月,观察组Barthel指数高于对照组(P<0.05)。结论替罗非班用于超时间窗急性后循环缺血性脑卒中患者的治疗是安全可行的,可改善神经功能缺损情况及凝血功能,提高日常生活活动能力,且不会增加出血事件发生风险。

Objective To explore the application effect of tirofiban in the treatment of acute posterior circulation stroke patients with over time window.Methods From December 2020 to June 2022,82 patients with acute posterior circulation stroke were selected in Beijing Changping District Hospital.According to different treatment methods,they were divided into the control group(n=32)and the observation group(n=50).The control group was treated with routine drugs,the observation group was treated with tirofiban based on the control group.NIHSS score before treatment and at 7,14 days after treatment,coagulation indexes before treatment and at 48 hours after treatment,incidence of bleeding events within 14 days after treatment,Barthel index before treatment and at 3,6 months after treatment were compared between the two groups.Results At 7,14 days after treatment,NIHSS score of the two groups were lower than those before treatment,and those in the observation group were lower than control group(P<0.01).At 48 hours after treatment,Fib level of the two groups was lower than that before treatment,PT,APTT were longer than those before treatment,and Fib level in the observation group was lower than that of the control group,PT,APTT were longer than those of the control group(P<0.05).There was no significant difference of incidence of bleeding events within 14 days after treatment between the two groups(P>0.05).At 3,6 months after treatment,Barthel index in the observation group was higher than that in the control group(P<0.05).Conclusion Tirofiban is safe and feasible in the treatment of patients with acute posterior circulation stroke with over time window,it can improve the coagulation function and neurological function of patients,and improve the activity of daily living,without increasing the risk of bleeding events.