替罗非班与阿司匹林、氯吡格雷双抗血小板方案治疗短暂性脑缺血发作的效果比较

Comparison of effects of tirofiban and dual antiplatelet regimen with aspirin and clopidogrel in the treatment of transient ischemic attack

目的:比较替罗非班与阿司匹林、氯吡格雷双抗血小板方案在短暂性脑缺血发作(Transient ischaemic attack,TIA)患者中的治疗效果差异。方法:选取2019年1月~2021年12月我院收治的96例TIA患者作为研究对象,根据治疗方案分为研究组与对照组,各48例。对照组采用阿司匹林与氯吡格雷治疗,研究组在对照组的基础上联合应用替罗非班进行治疗。比较治疗后两组患者疗效差异、对比治疗前后两组患者脑血流动力学指标变化、比较治疗结束3m后两组患者复发率及脑梗死发病率差异、以及两组患者药物不良反应发生概率。结果:治疗1 w后,研究组疗效明显高于对照组。两组患者最大血流速度、最小血流速度、平均血流速度以及平均血流量等指标均较治疗前有所改善,且研究组最大血流速度、最小血流速度、平均血流速度以及平均血流量等各项指标改善效果均明显高于对照组(P<0.05)。治疗结束3m后,研究组复发率及脑梗死发病率明显低于对照组(P<0.05)。治疗结束时两组患者药物不良反应发生率无明显差异(P>0.05)。结论:应用替罗非班与阿司匹林、氯吡格雷双抗血小板方案能够显著提高TIA患者治疗效果,改善其脑部血流供应,降低预后复发及脑梗死发生概率。

Objective:To compare the differences in therapeutic effects of tirofiban,dual antiplatelet regimen with aspirin and clopidogrel on patients with transient ischaemic attack(TIA).Methods:A total of 96 patients with TIA admitted to the hospital from January 2019 to December 2021 were retrospectively selected as the research subjects,and they were divided into the study group and the control group with 48 cases in each group according to the treatment regimens.The control group was treated with aspirin and clopidogrel,and the study group was combined with tirofiban on the basis of the control group.The difference in efficacy after treatment,changes in cerebral hemodynamic indicators before and after treatment,differences in recurrence rate and incidence rate of cerebral infarction at 3 months after the end of treatment and the incidence rates of adverse drug reactions were compared between the two groups of patients.Results:After 1 week of treatment,the efficacy of the study group was significantly higher than that of the control group.The maximum blood flow velocity,minimum blood flow velocity,average blood flow velocity and average blood flow of the two groups were improved compared with those before treatment,and the improvement effects of the above indicators in the study group were significantly higher than those in the control group(P<0.05).At 3 months after the end of treatment,the recurrence rate and the incidence rate of cerebral infarction were significantly lower in the study group than in the control group(P<0.05).At the end of treatment,there were no significant differences in the incidence rates of adverse drug reactions between the two groups(P>0.05).Conclusion:The application of tirofiban and dual antiplatelet regimen with aspirin and clopidogrel can significantly enhance the therapeutic effects of TIA patients,improve the cerebral blood supply,and reduce the probabilities of recurrence and cerebral infarction.