替罗非班对脑梗死静脉溶栓后24h内再加重患者治疗的疗效分析

Analysis of Efficacy of Exacerbation Combined with Tirofiban within 24 Hours after Intravenous Thrombolysis for Cerebral Infarction

目的:探讨时间窗内脑梗死静脉溶栓后24h内再加重患者联合替罗非班治疗的疗效。方法:回顾性分析2019-03—2021-03岳阳市中心医院神经科确诊为时间窗内脑梗死,并予以阿替普酶静脉溶栓后24h内神经功能障碍再加重的患者40例,根据是否使用替罗非班治疗分为常规治疗组(对照组,n=23)和替罗非班治疗组(n=17)。应用美国国立卫生研究院卒中量表(NIHSS)评估两组患者在第1天、第7天、第90天的神经功能障碍程度,并在第90天时应用改良的Rankin量表(mRS)评估所有患者的生活能力恢复情况,住院期间评估所有患者是否存在出血转化及90天是否存在死亡病例。结果:替罗非班治疗组患者第1天、第7天、第90天的神经功能障碍程度(NIHSS)均低于对照组(P<0.01);第90天mRS低于对照组(P<0.01)。替罗非班治疗组出现1例非症状性出血转化,2组均未出现死亡病例。结论:时间窗内脑梗死静脉溶栓后24h内再加重患者联合替罗非班治疗安全有效。

Objective:To investigate the therapeutic effect of tirofiban on patients with cerebral infarction exacerbation within 24 hours after intravenous thrombolysis in time window.Method:Retrospective analysis was performed on patients diagnosed with cerebral infarction within the time window and treated with exacerbation neurological dysfunction within 24 hours after intravenous thrombolysis with alteplase from March 2019 to March 2021.40 patients were divided into the conventional treatment group(n=23)and the tirofiban treatment group(n=17)according to whether they received tirofiban treatment or not.National institutes of health stroke scale(NIHSS)was used to assess the degree of neurological dysfunction on day 1,day 7,and day 90 of patients in the two groups,and modified rankin scale(mRS)was used to evaluate the recovery of living ability of all patients on day 90.All patients were evaluated for hemorrhagic transformation and for death at 90 days during hospitalization.Results:The degree of neurological dysfunction(NIHSS)in tirofiban treatment group on day 1,day 7 and day 90 was lower than that in control group(P<0.05);The recovery of living ability(mRS)on day 90 was higher than that of control group(P<0.05).In the treatment group,there was 1 case of asymptomatic bleeding transformation,and there was no death in the two groups.Conclusion:The combination of tirofiban and intravenous thrombolysis in cerebral infarction within 24 hours after exacerbation is safe and effective.