依达拉奉右莰醇联合替罗非班治疗颈动脉漂浮血栓相关脑梗死效果观察

Effect of Edaravond Dexcamphenol Combined with Tirofiban in the Treatment of Cerebral Infarction Associated with Floating Thrombus in Carotid Artery

目的 研究依达拉奉右莰醇联合替罗非班治疗颈动脉漂浮血栓相关脑梗死的效果。方法 选取2021年6月—2022年9月收治的颈动脉漂浮血栓相关脑梗死100例,根据治疗方法不同分为常规组、替罗非班组、依达拉奉组和联合组各25例。常规组予常规综合治疗,在此基础上,替罗非班组予替罗非班治疗,依达拉奉组予依达拉奉右莰醇治疗,联合组予依达拉奉右莰醇联合替罗非班治疗,各组疗程均为14 d。比较4组临床疗效,不同时点美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Bathel量表评分、炎性因子[超敏C反应蛋白(hs-CRP)、中性粒细胞与淋巴细胞比值(NLR)]水平,以及治疗安全性。结果 联合组疗效优于替罗非班组、依达拉奉组、常规组(P<0.05)。4组入院7、14、30、90 d NIHSS评分均低于入院时(P<0.05),且呈逐渐降低趋势;联合组入院7、14、30、90 d NIHSS评分低于替罗非班组、依达拉奉组及常规组(P<0.05)。入院90 d时4组mRS评分[常规组(3.48±0.45)分、替罗非班组(2.00±0.38)分、依达拉奉组(2.16±0.42)分、联合组(0.92±0.12)分]较入院时[常规组(4.28±0.65)分、替罗非班组(4.40±0.71)分、依达拉奉组(4.28±0.63)分、联合组(4.44±0.71)分]改善(P<0.05);联合组入院90 d时mRS评分低于替罗非班组、依达拉奉组及对照组(P<0.05)。入院90 d时4组Bathel量表评分均高于入院时(P<0.05);联合组入院90 d时Bathel量表评分高于依达拉奉组、替罗非班组、常规组(P<0.05)。4组入院7、14 d hs-CRP、NLR均低于入院时(P<0.05);联合组入院7、14 d hs-CRP、NLR均低于依达拉奉组、替罗非班组、常规组(P<0.05)。4组不良反应总发生率比较差异均无统计学意义(P>0.05)。结论 依达拉奉右莰醇联合替罗非班治疗颈动脉漂浮血栓相关脑梗死,能减小颈内动脉漂浮物,减轻神经缺损,提高患者日常生活能力,抑制炎症反应,从而增强疗效,且安全性高。

Objective To study the effect of Edaravond dexcamphenol combined with Tirofiban in the treatment of cerebral infarction associated with floating thrombus in carotid artery.Methods A total of 100 patients with cerebral infarction associated with floating thrombus in carotid artery admitted from June 2021 to September 2022 were selected and divided into conventional group(n=25),Tirofiban group(n=25),Edaravone group(n=25)and combination group(n=25)according to different treatment methods.The conventional group was treated with conventional comprehensive treatment,the Tirofiban group was treated with Tirofiban on the basis of the conventional group,the Edaravone group was treated with Edaravone dexcamphorol,and the combination group was treated with Edaravone dexcamphorol combined with Tirofiban.The course of treatment in each group was 14 d.Clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,Bathel score,inflammatory factors[hypersensitive C reactive protein(hs-CRP),neutrophil to lymphocyte ratio(NLR)]levels,and treatment safety were compared in the four groups.Results The curative effect of combination group was better than that of Tirofiban group,Edaravone group and conventional group(P<0.05).The NIHSS scores at 7,14,30 and 90 d after admission were lower than those at admission(P<0.05),and showed a gradually decreasing trend.The NIHSS scores of combination group were lower than those of Tirofiban group,Edaravone group and conventional group at 7,14,30 and 90 d after admission(P<0.05).At 90 d after admission,mRS scores in the four groups[(3.48±0.45)points in conventional group,(2.00±0.38)points in Tirofiban group,(2.16±0.42)points in Edaravone group,(0.92±0.12)points in combination group]were improved compared with those at admission[(4.28±0.65)points in conventional group,(4.40±0.71)points in Tirofiban group,(4.28±0.63)points in Edaravone group,(4.44±0.71)points in combination group](P<0.05).The mRS score of combination group was lower than that of Tirofiban group,Edaravone group and control group at 90 d after admission(P<0.05).At 90 d after admission,the Bathel score of the four groups was higher than that at admission(P<0.05).The Bathel score of combination group was higher than that of Edaravone group,Tirofiban group and conventional group at 90 d after admission(P<0.05).The hs-CRP and NLR of the four groups at 7 and 14 d after admission were lower than those at admission(P<0.05).hs-CRP and NLR in combination group were lower than those in Edaravone group,Tirofiban group and conventional group at 7 and 14 d after admission(P<0.05).There was no significant difference in total incidence of adverse reactions among the four groups(P>0.05).Conclusion Edaravond dexcamphenol combined with Tirofiban in the treatment of cerebral infarction associated with floating thrombus in carotid artery can reduce the floating substance of the internal carotid artery,reduce nerve defects,improve patients'ability of daily living,and inhibit inflammatory response,thus enhancing the efficacy with high safety.