尿激酶联合替罗非班序贯治疗急性缺血性脑卒中的临床观察

Clinical observation of sequential treatment of Urokinase and Tirofiban in acute ischemic stroke

目的探讨急性缺血性脑卒中患者利用尿激酶联合替罗非班序贯治疗的临床疗效。方法选取2018年1月至2019年10月甘肃省定西市人民医院神经内科收治的急性缺血性脑卒中患者67例,随机分为治疗组(n=33)与对照组(n=34)。对照组采用尿激酶静脉溶栓治疗,治疗组在对照组基础上序贯使用替罗非班治疗。观察治疗前后两组患者不同时间美国国立卫生院卒中量表(national institute of health stroke scale,NIHSS)评分、日常生活能力(activity of daily living,ADL)评分、90 d改良Rankin量表(90 d modified Rankin scale,mRS)评分等指标及不良反应发生情况。结果治疗后14 d,治疗组NHISS评分低于对照组,ADL评分高于对照组;治疗后90 d,治疗组mRS评分低于对照组;两组患者不良事件发生率比较差异无统计学意义。结论尿激酶联合替罗非班序贯治疗急性缺血性脑卒中有利于促进脑卒中患者神经功能恢复,改善患者预后。

Objective To explore clinical efficacy of urokinase combined with tirofiban in the treatment of acute ischemic stroke.Methods 67 patients with acute ischemic stroke who were treated in the Department of Neurology of Dingxi People's Hospital of Gansu Province from January 2018 to October 2019 were randomly divided into treatment group(n=33)and control group(n=34).The control group was treated with intravenous thrombolytic therapy of urokinase,and the treatment group was successively treated with tirofiban on the basis of the control group.After treatment,the total effectiveness,national institute of health stroke scale(NIHSS)score,activity of daily living(ADL)score,90 days modified Rankin scale(mRS)score and adverse events were observed between two groups at different time.Results At 14 days after treatment,the NHISS score of the treatment group was lower than that of the control group,and the ADL score was higher than that of the control group.The MRS score of the treatment group was lower than that of the control group at 90 days after treatment.There was no significant difference in the incidence of adverse events between the two groups.Conclusion Sequential treatment of urokinase and tirofiban in patients with acute ischemic stroke is beneficial to the recovery of neurological function and the prognosis of patients with stroke.