替罗非班联合丁苯酞治疗超时间窗急性脑梗死患者的效果评价

Effect Evaluation of Tirofiban Combined with Butylphthalide on Patients with Acute Cerebral Infarction beyond Time Window

目的:探究与分析替罗非班联合丁苯酞治疗超时间窗急性脑梗死患者的效果。方法:选取2020年1月-2021年9月龙岩市第二医院神经内科收治的108例超时间窗急性脑梗死患者作为研究对象,采取随机数字表法分为对照组与观察组,每组54例。对照组给予丁苯酞治疗,观察组给予丁苯酞联合替罗非班治疗。对比两组临床疗效、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、凝血功能指标、血清血红素加氧酶-1(HO-1)、血管生成素-1(Ang-1)、P-选择素(P-selectin)及溶酶体膜糖蛋白(CD63),对比治疗期间两组不良反应。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后14、28 d,观察组NIHSS评分均较对照组低,差异均有统计学意义(P<0.05)。治疗后,观察组血清HO-1、P-selectin、CD63水平均较对照组低,Ang-1水平较对照组高,差异均有统计学意义(P<0.05)。两组治疗前后血小板计数、凝血酶原时间、国际标准化比值比较,差异均无统计学意义(P>0.05)。两组治疗期间不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:超时间窗急性脑梗死患者行替罗非班联合丁苯酞治疗可改善神经功能缺损症状,调节血清HO-1、Ang-1、P-selectin及CD63水平,且不会对凝血功能带来不良影响,未增加明显的不良反应,安全性较高。

Objective: To explore and analyze the effect of Tirofiban combined with Butylphthalide on patients with acute cerebral infarction beyond time window. Method: A total of 108 patients with acute cerebral infarction beyond time window who were admitted to the Department of Neurology, the Second Hospital of Longyan from January 2020 to September 2021 were selected as the research subjects. They were divided into the control group and the observation group according to the random number table method, with 54 cases in each group. The control group was treated with Butylphthalide, and the observation group was treated with Tirofiban combined with Butylphthalide. The clinical efficacy, NIHSS scores, coagulation function index, serum heme oxygenase-1(HO-1),angiopoietins-1(Ang-1), P-selectin and lysosomal membrane glycoprotein(CD63) before and after treatment were compared between the two groups. Adverse reactions of the two groups during the treatment were compared.Result: The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). 14, 28 d after treatment, the NIHSS scores of the observation group were lower than those of the control group, the differences were statistically significant(P<0.05). After treatment, the levels of serum HO-1, P-selectin and CD63 in the observation group were lower than those of the control group, while the level of Ang-1 was higher than that of the control group, the differences were statistically significant(P<0.05).There were no significant differences in platelet count, prothrombin time and international standardized ratio between the two groups before and after treatment(P>0.05). There were no significant differences in the incidence of adverse reactions between the two groups during the treatment(P>0.05). Conclusion: Tirofiban combined with Butylphthalide on patients with acute cerebral infarction beyond time window can improve the symptoms of neurological deficits, and regulate serum HO-1, Ang-1, P-selectin, and CD63 levels, without causing adverse effects on coagulation function, without adding significant adverse reactions, with high safety.