替罗非班桥接双联抗血小板治疗急性脑梗死的疗效及安全性

The efficacy and safety of bridging dual antiplatelet therapy with tirofiban in acute cerebral infarction

目的探讨对急性脑梗死患者行拜阿司匹林和氯吡格雷双联抗血小板治疗与替罗非班联合应用的临床疗效及治疗安全性情况。方法选取2018年3月至2019年3月在我科住院接受治疗的90例急性脑梗死患者,按照单双病历号分为观察组和对照组,每组各45例。对照组接受拜阿司匹林和氯吡格雷双联抗血小板常规用药治疗,观察组在常规用药前先接受替罗非班静脉注射治疗。对比治疗后两组患者日常生活活动能力、神经功能改善情况以及治疗安全性情况。结果治疗半个月后,观察组总有效率为91.11%,明显高于对照组的66.67%,差异有统计学意义(P<0.05);观察组治疗3 d、半个月后的NIHSS评分为(9.08±0.29)分、(6.37±0.25)分,显著低于对照组的(10.28±0.43)分、(8.34±0.28)分,差异有统计学意义(P<0.05);观察组治疗3 d、半个月后的ADL评分为(43.97±2.03)分、(55.19±3.03)分,显著高于对照组的(35.99±1.92)分、(45.39±2.43)分,差异有统计学意义(P<0.05);两组患者不良事件总发生率比较,差异无统计学意义(P>0.05)。结论对急性脑梗死患者行拜阿司匹林和氯吡格雷双联抗血小板治疗与替罗非班联合应用具有较高的临床应用价值,且具有较高的治疗安全性。

Objective To analyze and investigate the clinical efficacy and treatment safety of bayaspirin and clopidogrel dual antiplatelet therapy combined with tirofiban for patients with acute cerebral infarction.Methods All 90 patients with acute cerebral infarction admitted to our department from March 2018 to March 2019 were selected according to odd and even medical record number,and they were divided into the observation group and the control group,with 45 cases in each group.Both groups were given bayaspirin and clopidogrel combined with dual antiplatelet therapy,while the observation group was given tirofiban combined with intravenous injection therapy before conventional medication.The activities of daily living(ADL),the improvement of neurological function and the safety of patients after treatment were compared.Results After half a month,the total efficacy rates in the observation group was 91.11%,which was higher than that of 66.67%in the control group,and the difference was statistically significant(P<0.05).The NIHSS scores in the observation group after 3 days and half a month were(9.08±0.29)points and(6.37±0.25)points,which were significantly lower than those of(10.28±0.43)points and(8.34±0.28)points in the control group,and the differences were statistically significant(P<0.05).The ADL scores in the observation group after 3 days and half a month were(43.97±2.03)points and(55.19±3.03)points in the observation group,which were significantly higher than those of(35.99±1.92)points and(45.39±2.43)points in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion The combination of bayaspirin and clopidogrel dual antiplatelet therapy combined with tirofiban in patients with acute cerebral infarction has relatively higher clinical application value and higher therapeutic safety.