替罗非班治疗急性脑梗死机械取栓术后患者的效果

Effects of Tirofiban on patients with acute cerebral infarction after mechanical thrombectomy

目的:观察替罗非班治疗急性脑梗死机械取栓术后患者的效果。方法:选取2019年1月至2022年1月茂名市人民医院神经内科收治的100例急性脑梗死患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。两组均采用机械取栓术治疗,术后对照组予以阿司匹林、氯吡格雷治疗,观察组在对照组基础上予以替罗非班治疗。比较两组临床疗效,治疗后血管再通率[脑梗死溶栓分级系统(TICI)],治疗前后神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、自理能力[Barthel指数(BI)]评分,治疗后随访6个月的预后[格拉斯哥预后评分法(GOS)]评分,以及不良反应发生率。结果:观察组治疗总有效率为94.00%(47/50),高于对照组的78.00%(39/50),差异有统计学意义(P<0.05);观察组血管再通率为90.00%(45/50),高于对照组的70.00%(35/50),差异有统计学意义(P<0.05);治疗后,观察组NIHSS评分低于对照组,BI和GOS评分均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在阿司匹林联合氯吡格雷治疗基础上采用替罗非班治疗急性脑梗死机械取栓术后患者可提高治疗总有效率、血管再通率、BI评分和GOS评分,降低NIHSS评分,效果优于单纯阿司匹林联合氯吡格雷治疗。

Objective:To observe effects of Tirofiban on patients with acute cerebral infarction after mechanical thrombectomy.Methods:A prospective study was conducted on 100 patients with acute cerebral infarction admitted to the Department of Neurology of Maoming People’s Hospital from January 2019 to January 2022.They were divided into control group and observation group according to the random number table method,50 cases in each.Both groups were treated with mechanical thrombectomy.After the surgery,the control group was treated with Aspirin and Clopidogrel,while the observation group was treated with Tirofiban on the basis of that of the control group.The clinical efficacy,the vascular recanalization rate[thrombolysis in cerebral infarction grading system(TICI)],the neurological deficit[National Institutes of Health Stroke scale(NIHSS)]score before and after the treatment,the self-care ability[Barthel Index(BI)]score,the prognosis[Glasgow outcome scale(GOS)]score at 6 months of follow-up after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 94.00%(47/50),which was higher than 78.00%(39/50)in the control group,and the difference was statistically significant(P<0.05).The vascular recanalization rate of the observation group was 90.00%(45/50),which was higher than 70.00%(35/50)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the NIHSS score of the observation group was lower than that of the control group,the BI and GOS scores were higher than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:On the basis of Aspirin combined with Clopidogrel,Tirofiban in the treatment of the patients with acute cerebral infarction after mechanical thrombectomy can improve the total effective rate of treatment,the vascular recanalization rate,the BI score and the GOS score,and reduce the NIHSS score.Moreover,it is superior to single Aspirin combined with Clopidogrel treatment.