替罗非班联合尿激酶溶栓治疗急性缺血性卒中的临床观察

Observation on the effect of tirofiban combined with urokinase thrombolysis on patients with acute ischemic stroke

目的探讨替罗非班联合尿激酶溶栓治疗急性缺血性卒中(AICS)的临床效果。方法抽取2018年2月至2021年2月南石医院收治的AICS患者150例, 按随机数字表法分为研究组与对照组, 每组75例, 对照组采用尿激酶溶栓, 研究组采用替罗非班联合尿激酶溶栓, 比较两组疗效, 治疗前后血小板参数、Barthel指数(BI)、美国国立卫生院卒中量表(NIHSS)评分, 比较继发性疾病发生率、Rankin修订量表(mRS)评分。结果研究组总有效率(93.33%)较对照组(77.33%)高(P<0.05);治疗后, 研究组血小板平均分布宽度(PDW)较对照组低, 血小板压积(PCT)较对照组高(P<0.05);治疗后, 研究组BI评分较对照组高, NIHSS评分较对照组低(P<0.05);研究组继发性疾病发生率(5.33%)较对照组(16.00%)低(P<0.05);研究组mRS评分较对照组低(P<0.05)。结论 AICS患者采用替罗非班、尿激酶溶栓联合治疗效果确切, 可改善血小板参数, 减轻神经功能缺损, 提高日常生活能力, 降低继发性疾病发生率, 改善预后。

Objective To analyze the clinical effect of tirofiban combined with urokinase thrombolytic therapy on patients with acute ischemic stroke(AICS).Methods A total of 150 AICS patients in Nanshi Hospital from February 2018 to February 2021 were selected,and divided into study group and control group according to random number table method,with 75 patients in each group.The control group received thrombolysis by urokinase,and the study group received thrombolysis by tirofiban combined with urokinase.The efficacy,platelet parameters,Barthel index(BI),National Institutes of Health Stroke Scale(NIHSS)scores before and after treatment were compared between the two groups.The incidence of secondary diseases and Rankin revised scale scores(mRS)were compared.Results The total effective rate of the study group(93.33%)was higher than that of the control group(77.33%),P<0.05.After treatment,the mean platelet distribution width(PDW)of the study group was lower than that of the control group,and the platelet hematocrit(PCT)was higher than that of the control group(P<0.05).After treatment,BI score of the study group was higher than that of the control group,and NIHSS score was lower than that of the control group(P<0.05).The incidence of secondary diseases in the study group(5.33%)was lower than that in the control group(16.00%),P<0.05.The MRS score of the study group was lower than that of the control group(P<0.05).Conclusions The combination of tirofiban and urokinase thrombolytic therapy for AICS patients has a definite effect,which can improve platelet parameters,reduce neurological impairment,improve the ability of daily living,reduce the incidence of secondary diseases and improve the prognosis.