替罗非班桥接双抗治疗醒后卒中的疗效及安全性研究

Efficacy and safety evaluation of tirofiban bridging dual antiplatelet in the treatment of wake-up stroke

目的探讨早期应用替罗非班桥接阿司匹林和氯吡格雷双抗治疗超时间窗的醒后卒中患者的安全性及有效性。方法选取潍坊医学院附属医院2018-01—2020-01收治的醒后卒中患者112例为研究对象,依据随机数表法分为对照组和观察组,对照组(n=56)接受氯吡格雷和拜阿司匹林治疗,观察组(n=56)接受替罗非班桥接双抗治疗,比较2组患者治疗前后神经功能评分(采用美国国立卫生研究院卒中量表评分)、评价预后功能的改良Rankin量表(mRS)评分及不良事件(出血及死亡)。结果2组治疗后NIHSS评分较治疗前下降,治疗组下降更明显,差异有统计学意义(P<0.05);观察组的预后良好比例(mRS≤2.0)较对照组明显增多,差异有统计学意义(P<0.05);观察组总有效率较对照组明显增高,差异有统计学意义(P<0.05);在出血、死亡等不良反应方面,2组相比差异无统计学意义(P>0.05)。结论替罗非班桥接双抗治疗醒后卒中是一种安全有效的治疗策略。

Objective To explore the safety and efficacy of early tirofiban bridging aspirin and clopidogrel in patients with wake-up stroke after prolonged time window.Methods A total of 112 patients with wake-up stroke in our hospital(from January 2018 to January 2020)were selected as study subjects.All patients were divided into the control group and the observation group ac⁃cording to the random number table method,the control group(n=56)was treated with clopidogrel and aspirin,and the observation group(n=56)was treated with tirofiban bridging aspirin and clopidogrel,NIHSS score,mRS score and prognosis(bleeding and death)were compared before and after treatment.Results The NIHSS scores of the two groups decreased after treatment,especially in the observation group,there was significant difference(P<0.05).The rate of good prognosis(mRS≤2.0)in the observation group was significantly higher than that in the Control Group(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in side effects such as bleeding and death be⁃tween the two groups(P>0.05).Conclusion Tirofiban bridging aspirin and clopidogrel in the treatment of wake-up stroke is safety and efficacy.