不同药物治疗进展性脑卒中合并血管狭窄的治疗效果分析

Analysis of Therapeutic Effects of Different Drugs on Progressive Stroke Complicated With Vascular Stenosis

目的 探讨替罗非班与阿加曲班在进展性脑卒中合并血管狭窄患者治疗中的临床运用价值。方法 方便选择2019年1月—2021年12月期间苏州大学附属张家港医院收治的220例进展性脑卒中合并血管狭窄患者为研究对象,根据数字随机法将其分为两组,各110例。对照组给予替罗非班治疗,观察组给予阿加曲班治疗,比较分析两组治疗效果。结果 治疗前,两组神经功能缺损程度量表(NDS)和美国国立卫生研究院卒中量表(NIHSS)评分比较,差异无统计学意义(P>0.05);治疗后,两组的NIHSS和NDS评分均低于治疗前,差异有统计学意义(P<0.05),两组NIHSS和NDS评分比较,差异有统计学意义(P<0.05);观察组的治疗有效率高于对照组,差异有统计学意义(P<0.05);两组治疗前的凝血4项指标对比,差异无统计学意义(P>0.05);观察组治疗后的纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)水平均低于对照组,且凝血酶原时间(PT)、凝血酶时间(TT)水平高于对照组,差异有统计学意义(P<0.05);治疗前,两组的日常生活活动能力比较,差异无统计学意义(P>0.05);治疗后,观察组日常生活能力评分高于对照组,差异有统计学意义(P<0.05);两组治疗前的血清炎性因子水平比较,差异无统计学意义(P>0.05);观察组治疗后的超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)水平均低于对照组,差异有统计学意义(P<0.05);观察组的、中度狭窄以及重度狭窄率分别为、34.55%、9.09%,均优于对照组的、61.82%、24.55%,差异有统计学意义(Z=44.989,P<0.05);观察组并发症发生率为7.27%,和对照组的9.09%比较,差异无统计学意义(χ^(2)=0.242,P>0.05)。结论 临床上运用替罗非班和阿加曲班对进展性脑卒中合并血管狭窄患者进行治疗,均可以使神经系统功能缺损得到改善,减轻机体炎症反应,并且不良反应发生率低,其中阿加曲班可以获得较好的效果,可以作为首选的一种治疗药物。

Objective To investigate the clinical application value of tirofiban and agaltreban in the treatment of patients with progressive stroke complicated with vascular stenosis.Methods A total of 220 patients with progressive stroke complicated with vascular stenosis admitted to Zhangjiagang Hospital affiliated with Suzhou University from January 2019 to December 2021 were conveniently selected as the study subjects.They were randomly divided into two groups using a digital randomization method,with 110 patients in each group.The control group was treated with tirofiban,and the observation group was treated with agatroban.Comparative analysis of the two groups of treatment effects.Result Before treatment,there was no statistically significant difference in Neurological Deficiency Score(NDS)and National Institute of Health Stroke Scale(NIHSS)scores between the two groups(P>0.05).After treatment,the NIHSS and NDS scores of both groups were lower than before treatment,the difference was statistically significant(P<0.05).There was statistically significant difference in NIHSS and NDS scores between the two groups(P<0.05).The treatment effectiveness rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the four coagulation indicators before treatment between the two groups(P>0.05).The levels of fibrinogen(FIB)and activated partial thromboplastin time(APTT)in the observation group after treatment were lower than those in the control group,and the prothrombin time(PT),thrombin time(TT)levels were higher than those in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in daily living activities between the two groups(P>0.05).After treatment,the daily living ability score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of serum inflammatory factors between the two groups before treatment(P>0.05).Observation group's hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α,(TNF-α),interleukin-6(IL-6)was lower than that of the control group,and the difference was statistically significant(P<0.05).The rates of,moderate stenosis,and severe stenosis in the observation group were 34.55%,and 9.09%,respectively,which were superior to the control group's 61.82%,and 24.55%,the difference was statistically significant(Z=44.989,P<0.05).The incidence of complications in the observation group was 7.27%,and there was no statistically significant difference compared to the control group's 9.09%(χ^(2)=0.242,P>0.05).Conclusion the clinical use for class and aga class had to advanced merger stenosis of cerebral apoplexy patients for treatment,all can improve neurological function defect,reduce the body's inflammatory response,and low incidence of adverse reactions,which can obtain good effect,music class,a drug can be used as the preferred.