替罗非班联合依达拉奉治疗急性进展性脑梗死的疗效及对神经功能的影响

Efficacy and Neurological Effect of Tirofiban Combined with Edaravone in the Treatment of Acute Progressive Cerebral Infarction

目的研究替罗非班联合依达拉奉治疗急性进展性脑梗死(APCI)的疗效及对神经功能的影响。方法选取本院收治的92例APCI患者(2020年10月至2022年5月),按随机数表法将患者分为对照组(46例)和实验组(46例)。对照组采用依达拉奉治疗,实验组采用替罗非班联合依达拉奉治疗。比较两组疗效,治疗前、治疗两周后日常生活能力Bathel指数量表(BI)、美国国立卫生研究院卒中量表(NIHSS)评分、血液流变学指标(纤维蛋白原、全血低切黏度、血浆黏度、全血高切黏度)、血清脂蛋白相关性磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)、TGF-β1、Cav-1水平及不良反应发生率。结果实验组临床总有效率93.48%(43/46)高于对照组78.26%(36/46),差异有统计学意义(P<0.05);治疗两周后,实验组BI评分高于对照组,NIHSS评分低于对照组,差异有统计学意义(P<0.05);治疗两周后,实验组血浆黏度、全血低切黏度、全血高切黏度、纤维蛋白原水平低于对照组,差异有统计学意义(P<0.05);治疗两周后,实验组血清Lp-PLA2、Hcy、Cav-1水平低于对照组,TGF-β1水平高于对照组,差异有统计学意义(P<0.05);治疗2周后实验组不良反应总发生率10.87%(5/46)与对照组6.52%(3/46)相比,差异无统计学意义(P>0.05)。结论替罗非班联合依达拉奉治疗APCI患者疗效显著,可有效缓解临床症状,调节血液流变学,促进病情恢复。

Objective To study the efficacy of tirofiban combined with edaravone in the treatment of acute progressive cerebral infarction(APCI)and its effects on neurological function.Methods The 92 patients with APCI admitted to our hospital(October 2020 to May 2022)were divided into control group(n=46)and experimental group(n=46)according to the random number table method.The control group was treated with edaravone,and the experimental group was treated with tirofiban combined with edaravone.The efficacy,Bathel index scale(BI),NIHSS,blood rheological indexes(fibrinogen,whole blood low cut viscosity,plasma viscosity,whole blood high cut viscosity),serum lipoprotein-associated phospholipase A2(Lp-PLA2),homocysteine(Hcy),TGF-β1,Cav-1 levels and the incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate of the experimental group was 93.48%(43/46)higher than that of the control group 78.26%(36/46)(P<0.05);the BI score of the experimental group after 2w treatment was higher than that of the control group,and the NIHSS score was lower than that of the control group(P<0.05);the plasma viscosity,whole blood low cut viscosity,whole blood high cut viscosity and fibrinogen levels of the experimental group after 2w treatment were lower than that of the control group(P<0.05);after 2w treatment,the experimental group had serum Lp-PLA2,Hcy,The level of Cav-1 was lower than that of the control group,and the level of TGF-β1 was higher than that of the control group(P<0.05),and the total incidence of adverse reactions in the experimental group after 2w treatment was 10.87%(5/46)compared with 6.52%(3/46)in the control group(P>0.05).Conclusion Tirofiban combined with edaravone has a significant effect in the treatment of APCI patients,which can effectively alleviate clinical symptoms,regulate blood rheology,and promote disease recovery.