替罗非班对进展性脑梗死神经功能缺损及血清S100B蛋白和NSE的影响

Effect of tirofiban in progressive cerebral infarction of neurological deficits,S100B protein and NSE

目的分析替罗非班对进展性脑梗死急性期神经功能缺损(NIHSS)评分、血清S100B蛋白、神经元特异性烯醇化酶(NSE)的作用及6个月后NIHSS评分的影响。方法选取新郑市公立人民医院2020-04-2022-10收治的急性进展性脑梗死患者126例为研究对象,均为颈内动脉系统梗死,分为治疗组和对照组,对照组常规应用药物阿司匹林、氢氯吡格雷、阿托伐他汀钙等治疗,治疗组在此基础上应用替罗非班代替阿司匹林和氢氯吡格雷治疗24 h,其余治疗同对照组,对比2组患者NIHSS得分、血清S100B蛋白、NSE在治疗前、治疗后24 h、治疗后72 h及6个月后NIHSS评分的差异。结果治疗前2组患者各项指标比较差异无统计学意义(P>0.05),对照组治疗后24 h及72 h NIHSS、血清S100B蛋白、NSE较治疗前明显下降(P<0.05),治疗组治疗后24 h及72 h NIHSS、血清S100B蛋白、NSE明显下降(P<0.05)。治疗后24 h、72 h治疗组较对照组NIHSS、血清S100B蛋白、NSE明显下降(P<0.05)。6个月后治疗组NIHSS评分低于对照组。2组患者均无脑出血、严重过敏等严重不良反应。结论替罗非班可显著改善急性进展性脑梗死患者神经功能缺损评分,明显降低血清S100B蛋白、NSE,并明显改善加重后6个月的神经功能缺损。

Objective To investigate the effect of tirofiban on acute neurological impairment(NIHSS)score,serum S100B protein,neuron-specific enolase(NSE)and NIHSS score after 6 months of progressive cerebral infarction.Methods A total of 126 patients with acute progressive cerebral infarction admitted to Public People’s Hospital of Xinzheng from April 2020 to October 2022 were selected as the study objects,all of them were internal carotid artery system infarction.They were divided into treatment group and control group.The control group was routinely treated with aspirin,hydroclopidogrel,atorvastatin calcium,etc.On this basis,the treatment group was treated with Tirofiban instead of aspirin and hydroclopidogrel for 24 hours,and the other treatments were compared with the control group.The NIHSS scores,serum S100B protein and NSE levels of the two groups were compared before treatment,24 hours after treatment,72 hours after treatment and 6 months after treatment.Results There were no statistically significant differences in various indexes between the two groups before treatment(P>0.05).NIHSS score,serum S100B protein and NSE levels in the control group were significantly decreased at 24 h and 72 h after treatment(P<0.05).In the treatment group,NIHSS score,serum S100B protein and NSE levels were significantly decreased at 24 h and 72 h after treatment(P<0.05).NIHSS score,serum S100B protein and NSE levels in the treatment group were significantly decreased at 24 h and 72 h after treatment compared with the control group(P<0.05).After 6 months,the NIHSS score of treatment group was lower than that of control group.There were no serious adverse reactions such as cerebral hemorrhage and severe allergy in the two groups.Conclusion Tirofiban can significantly improve the neurological deficit score in patients with acute progressive cerebral infarction,significantly reduce serum S100B protein and NSE levels,and significantly improve the neurological deficit at 6 months after exacerbation.