替罗非班治疗急性进展性后循环缺血性脑卒中的疗效观察

Therapeutic efficacy of intravenous tirofiban in acute progressive posterior circulation stroke

目的探讨急性进展性后循环缺血性脑卒中患者应用替罗非班的临床疗效。方法分析2017年10月~2020年10月解放军北部战区空军医院神经内科收治的急性进展性后循环缺血性脑卒中患者55例的临床资料,根据患者是否应用替罗非班分为治疗组30例和对照组25例。收集患者临床资料,全身系统性出血、颅内出血情况,比较2组预后,改良的Rankin量表(mRS)评分≤2分为预后良好。结果2组病情进展后美国国立卫生研究院卒中量表(NIHSS)评分比较,无统计学差异(P>0.05),治疗组发病14 d时NIHSS评分明显低于对照组[7(2,8)分vs 8(2,12)分,P=0.038],治疗3个月良好预后比例明显高于对照组(50.0%vs 32.0%,P=0.014)。2组治疗7 d内均无颅内出血转化发生。结论急性进展性后循环缺血性脑卒中患者早期应用替罗非班可能是有效治疗方法。

Objective To investigate the curative efficacy of intravenous tirofiban in patients with acute progressive posterior circulation ischemic stroke.Methods The clinical data of 55 patients with acute progressive posterior circulation ischemic stroke admitted to our neurology department from October 2017 to October 2020 were collected and analyzed.They were divided into treatment group(n=30)and control group(n=25)according to whether they had received tirofiban or not.Their general data and systemic and cerebral hemorrhage conditions were collected.The prognosis of the 2 groups was compared with mRS,and those with mRS score≤2 were classified as good prognosis.Results There was no significant difference in the NIHSS scores between the two groups after progression(P>0.05).The treatment group obtained obviously lower score of NIHSS at 14 d after onset[7(2,8)points vs 8(2,12)points,P=0.038],and larger proportion of achieving good prognosis at 3 months after treatment than the control group(50.0%vs 32.0%,P=0.014).No intracranial hemorrhage transformation was seen in two groups within 7 d.Conclusion Early application of tirofiban may be an effective treatment in patients with acute progressive posterior circulation ischemic stroke.