替罗非班治疗超时间窗急性后循环脑卒中效果及对炎性因子、凝血功能的影响

Clinical Efficacy of Tirofiban in Treatment of Patients with Acute Posterior Circulation Stroke Beyond the Time Window and Its Effects on Inflammatory Factors and Coagulation Function

目的探讨替罗非班对超时间窗急性后循环缺血性脑卒中的疗效及对炎性因子、凝血功能的影响。方法选取2018年9月—2020年6月收治的超时间窗急性后循环缺血性脑卒中114例,按治疗方法分为替罗非班组和对照组,每组57例。对照组于造影检查结束后给予抗血小板聚集联合强化降脂治疗,替罗非班组于造影检查结束后给予替罗非班及抗血小板聚集联合强化降脂治疗。记录2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、炎性因子、凝血功能及日常生活活动能力(Barthel)指数量表评分变化,评价治疗安全性。结果替罗非班组治疗后NIHSS评分、白细胞介素-1β、肿瘤坏死因子-α、超敏C反应蛋白、纤维蛋白原低于对照组,活化部分凝血活酶时间、凝血酶原时间、Barthel指数高于对照组(P<0.05)。2组治疗后出血发生率比较差异无统计学意义(P>0.05)。结论替罗非班可有效提高超时间窗急性后循环缺血性脑卒中临床疗效,减轻机体炎症反应,改善机体凝血功能,提高患者日常生活能力,且具有较高的安全性。

Objective To investigate clinical efficacy of Tirofiban in treatment of patients with acute posterior circulation ischemic stroke(PCIS)beyond the time window and its effects on inflammatory factors and coagulation function.Methods A total of 114 patients with acute PCIS beyond the time window admitted between September 2018 and June 2020 were selected and divided into Tirofiban group(n=57)and control group(n=57)according to different therapeutic methods.Control group was treated with antiplatelet aggregation combined with intensive lipid-lowering therapy after angiography,while Tirofiban group was treated with Tirofiban on the basis of treatment for control group.Changes of National Institutes of Health Stroke Scale(NIHSS)scores,inflammatory factors,coagulation function and activity of daily living(ADL)scale(Barthel Index)before and after treatment were recorded to evaluate the safety of treatment in two groups.Results After treatment,in Tirofiban group,NIHSS score and levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)and fibrinogen(FIB)were significantly lower,while values of activated partial thromboplastin time(APTT),prothrombin time and Barthel index were significantly higher than those in control group(P<0.05).There was no significant difference in incidence rate of bleeding after treatment between two groups(P>0.05).Conclusion Tirofiban may effectively improve clinical efficacy,reduce inflammatory reaction of the body,and improve coagulation function of the body and ADL with good safety in treatment of patients with acute PCIS beyond the time window.