缺血性脑卒中经尿激酶静脉溶栓后联合替罗非班治疗效果、血小板相关参数变化及安全性观察

Observation on efficacy,platelet-related parameter changes and safety of urokinase intravenous thrombolysis combined with tirofiban in the treatment of ischemic stroke

目的 分析缺血性脑卒中经尿激酶静脉溶栓后联合替罗非班治疗效果、血小板相关参数变化及安全性。方法 154例缺血性脑卒中患者,按不同治疗手段分为单一组75例(尿激酶静脉溶栓治疗)和联合组79例(尿激酶静脉溶栓后联合替罗非班治疗)。比较两组临床治疗效果、血小板相关参数、日常生活能力、神经功能及并发症发生情况。结果 联合组总有效率高于对照组(P<0.05)。治疗后,两组血小板平均分布宽度(PDW)、血小板聚集率(PAgT)、血小板粘附率(PAdT)及NIHSS评分较治疗前降低,血小板压积(PCT)、Barthel指数较治疗前增高,且联合组上述指标变化程度均大于单一组(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论 经尿激酶静脉溶栓后联合替罗非班治疗缺血性脑卒中患者疗效确切,可改善患者神经功能、血小板功能,提高其日常生活能力,且安全可靠。

Objective To analyze the curative effects of urokinase intravenous thrombolysis combined with tirofiban in the treatment of ischemic stroke as well as platelet-related parameters and safety.Methods One hundred and fifty-four patients with ischemic stroke were divided into a single group(urokinase intravenous thrombolysis therapy, n=75) and a combined group(urokinase intravenous thrombolysis combined with tirofiban therapy, n=79) according to different treatment methods. The clinical treatment effect, platelet related parameters, daily living ability, neurological function and complications were compared between the two groups.Results The total effective rate of the combined group was higher than that of the single group(P<0.05). After treatment, the average platelet distribution width(PDW), platelet aggregation rate(PAgT), platelet adhesion rate(PAdT) and NIHSS score of the two groups were lower while the platelet hematocrit(PCT) and Barthel index were higher than those before treatment in both groups, and the changes of the above indexes in the combined group were greater than those in the single group(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions Urokinase intravenous thrombolysis combined with tirofiban is effective in the treatment of ischemic stroke patients. The treatment can improve the neurological function, platelet function and daily living ability of patients. It is safe and reliable.