不同剂量盐酸替罗非班治疗急性非心源性脑梗死患者的疗效及对凝血功能的影响

Effect of different doses of tirofiban hydrochloride in the treatment of patients with acute non-cardiogenic cerebral infarction and its influence on coagulation function

目的分析不同剂量盐酸替罗非班治疗急性非心源性脑梗死患者的疗效及对凝血功能的影响。方法以2021-04—2022-04河北燕达医院的240例急性非心源性脑梗死患者为研究对象,利用计算机生成的随机数列分为对照组、观察一组、观察二组、观察三组,每组60例。对照组采用常规对症治疗,观察一组、观察二组、观察三组在对照组基础上分别给予0.06μg(/kg·min)、0.08μg(/kg·min)和0.1μg(/kg·min)盐酸替罗非班。比较4组血常规指标[血小板计数(PC)、血小板聚集率、平均血小板体积(MPV)、淋巴细胞(LYM)及平均血小板体积/淋巴细胞比值(MPVLR)]及凝血四项指标[凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)],分析4组美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分。结果治疗3个月后,观察三组PC、血小板聚集率、LYM、MPV、MPVLR均低于对照组、观察一组、观察二组(P<0.05),观察三组PT、TT和APTT均高于对照组、观察一组和观察二组(P<0.05),观察三组FIB、NIHSS、mRS评分均低于对照组、观察一组、观察二组(P<0.05)。结论0.10μg(/kg·min)盐酸替罗非班治疗急性非心源性脑梗死患者的疗效较好,抗凝血作用较强,有利于抑制和预防血栓形成。

Objective To analyze the therapeutic effect of different doses of tirofiban hydrochloride in the treatment of patients with acute non-cardiogenic cerebral infarction and its influence on coagulation function.Methods Totally 240 patients with acute non-cardiogenic cerebral infarction in Hebei Yanda Hospital from April 2021 to April 2022 were taken as the research objects,and were randomly divided into control group,observation groupⅠ,observation groupⅡ,and observation groupⅢby computer generated random number sequence,with 60 cases in each group.The control group was treated with conventional symptomatic treatment.Observation groupⅠ,observation groupⅡand observation groupⅢwere given respective 0.06μg(/kg·min),0.08μg(/kg·min)and 0.1μg/(kg·min)tirofiban hydrochloride on the basis of the control group.Blood routine indicators(platelet count(PC),platelet aggregation rate,mean platelet volume(MPV),lymphocyte(LYM)and mean platelet volume/lymphocyte(MPVLR))and four coagulation indicators(prothrombin time(PT),fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(APTT))in the four groups were compared,and National Institutes of Health stroke scale(NIHSS),modified Rankin scale(mRS)scores of the four groups were analyzed.Results After 3 months of treatment,the PC,platelet aggregation rate and LYM of observation groupⅢwere lower than those of the control group,observation groupⅠand observation groupⅡ(P<0.05).The MPV and MPVLR of observation groupⅢwere lower than those of the control group,observation groupⅠand observation groupⅡ(P<0.05).The PT,TT and APTT of observation groupⅢwere higher than those of the control group,observation groupⅠand observation groupⅡ(P<0.05).The FIB,NIHSS and mRS scores of observation groupⅢwere lower than those of the control group,observation groupⅠand observation groupⅡ(P<0.05).Conclusion 0.10μg(/kg·min)tirofiban hydrochloride has a good effect in the treatment of patients with acute non-cardiogenic cerebral infarction.It has a strong anticoagulant effect,and is conducive to inhibiting and preventing thrombosis.