替罗非班联合常规抗血小板药治疗超溶栓时间窗脑梗死患者的效果

Effects of Tirofiban combined with conventional antiplatelet drugs in treatment of patients with cerebral infarction beyond the thrombolysis time window

目的:观察替罗非班联合常规抗血小板药治疗超溶栓时间窗脑梗死患者的效果。方法:选取2021年1月至2022年12月该院收治的120例超溶栓时间窗脑梗死患者进行前瞻性研究。按照随机数字表法将其分为对照组和观察组各60例。对照组采用常规双联抗血小板(阿司匹林肠溶片+硫酸氢氯吡格雷片)治疗,观察组在对照组的基础上联合盐酸替罗非班氯化钠注射液治疗。比较两组临床疗效,治疗前后神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、认知功能[蒙特利尔认知评估量表(MoCA)]评分、血清生化指标[血管生成素-1(Ang-1)、P选择素、一氧化氮(NO)、血管内皮生长因子(VEGF)]水平,以及不良反应发生率。结果:观察组治疗总有效率为96.67%(58/60),高于对照组的86.67%(52/60),差异有统计学意义(P<0.05);治疗后,观察组NIHSS评分、P选择素水平低于对照组,MoCA评分及Ang-1、NO、VEGF水平高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:替罗非班联合常规双联抗血小板治疗超溶栓时间窗脑梗死患者效果显著,可减轻血管内皮损伤、神经功能缺损程度,提高认知功能,效果优于单用双联抗血小板治疗。

Objective:To observe effects of Tirofiban combined with conventional antiplatelet drugs in treatment of patients with cerebral infarction beyond the thrombolysis time window.Methods:A prospective study was conducted on 120 patients with cerebral infarction beyond thrombolysis time window admitted to the hospital from January 2021 to December 2022.According to the random number table method,they were divided into control group and observation group,60 cases in each group.The control group was treated with conventional dual antiplatelet(Aspirin enteric-coated tablets+Clopidogrel hydrogen sulfate tablets),while the observation group was treated with Tirofiban hydrochloride sodium chloride injection on the basis of that of the control group.The clinical efficacy,the levels of neurological deficit degree[National Institutes of Health stroke scale(NIHSS)],the cognitive function[Montreal cognitive assessment(MoCA)],the serum biochemical indexes[Angiopoietin-1(Ang-1),P-selectin,nitric oxide(NO),vascular endothelial growth factor(VEGF)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 96.67%(58/60),which was higher than that of the control group 86.67%(52/60),and the difference was statistically significant(P<0.05).After the treatment,the NIHSS score and the P-selectin level in the observation group were lower than those in the control group,the MoCA score and the levels of Ang-1,NO and VEGF were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Tirofiban combined with conventional dual antiplatelet therapy has a significant effect on the patients with cerebral infarction beyond the thrombolysis time window,which can reduce the vascular endothelial injury and neurological deficits and improve the cognitive function.Moreover,it is superior to simple dual antiplatelet therapy.