替罗非班治疗急性进展性脑梗死患者的疗效及对炎性因子的影响

Effect of Tirofiban in the Treatment of Patients with Acute Progressive Cerebral Infarction and Its Effect on Inflammatory Factors

目的观察替罗非班治疗急性进展性脑梗死患者的疗效及对炎性因子的影响。方法选取2018年6月至12月泰山医学院附属聊城市第二人民医院神经内科确诊为急性进展性脑梗死患者80例,随机分为替罗非班治疗组(替罗非班静脉输注72 h后停用,继用口服阿司匹林联合氯吡格雷)和对照组(口服阿司匹林联合氯吡格雷),两组均连续治疗3个月。比较两组治疗前后美国国立卫生研究院卒中量表(NHISS)评分、生活能力(MRS)评分及超敏C反应蛋白(hs-CRP)及纤维蛋白原(Fib)炎性因子水平。结果两组患者治疗前NHISS及MRS评分比较,差异无统计学意义(P>0.05)。与本组治疗前比较,两组治疗后NHISS评分、MRS评分、hs-CRP水平及Fib水平均降低,替罗非班组降低更加显著,差异均有统计学意义(P<0.05)。对照组有1例患者在观察期间出现消化道出血,替罗非班组无明显药物不良反应。结论替罗非班对急性进展性脑梗死患者的治疗效果显著,而且能够降低炎性因子水平,安全性高。

Objective To observe the efficacy of tirofiban in the treatment of patients with acute progressive cerebral infarction and its effect on inflammatory factors.Methods Eighty patients with acute progressive cerebral infarction diagnosed by Department of Neurology,Liaocheng Second People's Hospital of Taishan Medical College from June to December 2018 were randomly divided into tirofiban group(intravenous infusion of tirofiban).After 72 h,discontinuation,followed by oral aspirin plus clopidogrel and the control group(oral aspirin plus clopidogrel),the two groups were treated continuously for 3 months.The National Institutes of Health Stroke Scale(NHISS)score,viability(MRS)score,and high-sensitivity C-reactive protein(hs-CRP)and fibrinogen(Fib)inflammatory factors were compared between the two groups.Results There was no significant difference in the scores of NHISS and MRS between the two groups before treatment(P>0.05).Compared with before treatment,the NHISS score,MRS score,hs-CRP level and Fib level decreased after treatment,and the reduction was more significant in the tirofiban group(P<0.05).In the control group,1 patient developed gastrointestinal bleeding during the observation period,and there was no obvious adverse drug reaction in the tirofiban group.Conclusion Tirofiban has a significant therapeutic effect on patients with acute progressive cerebral infarction,and it can reduce the level of inflammatory factors and has high safety.