盐酸替罗非班联合丁苯酞注射液对穿支动脉脑梗死患者临床预后的影响

Effects of tirofiban hydrochloride combined with butylphthalide injection on clinical prognosis in patients with perforator artery cerebral infarction

目的分析穿支动脉脑梗死患者采用盐酸替罗非班联合丁苯酞注射液治疗对其临床预后的影响,以期为临床治疗穿支动脉脑梗死患者提供参考。方法选取86例2021年3月至2023年10月濮阳市安阳地区医院收治的穿支动脉脑梗死患者开展前瞻性研究,将86例患者按随机数字表法分组,分为对照组(43例)与研究组(43例)。对照组予丁苯酞注射液治疗,研究组予盐酸替罗非班联合丁苯酞注射液治疗,2组治疗周期为2周。对2组患者临床效果,治疗前及治疗2周后D-二聚体、凝血酶原时间、纤维蛋白原水平,治疗前及治疗1、2周后胱抑素C、同型半胱氨酸水平,以及治疗1、2周后改良Rankin量表(mRS)、Barthel指数(BI)进行比较。结果经过临床治疗,对照组、研究组的临床治疗有效患者分别为33例,40例,占77%、93%,研究组相较于对照组高(χ^(2)=4.440,P=0.035);2组治疗2周后相较于治疗前,D-二聚体、纤维蛋白原水平均降低,研究组较对照组降低更明显(t=27.371,6.088,P均<0.05);凝血酶原时间均延长,研究组较对照组延长更明显(t=2.463,P<0.05);2组治疗1、2周后相较于治疗前,胱抑素C、同型半胱氨酸水平均降低,研究组较对照组降低更明显(t=3.026、3.936,6.204、8.381,P均<0.05);2组治疗2周后相较于治疗1周后,mRS评分均降低,BI评分均升高,研究组较对照组mRS评分降低更明显(t=10.705,P<0.05),BI评分升高更明显(t=12.500,P<0.05)。结论采用盐酸替罗非班联合丁苯酞注射液治疗穿支动脉脑梗死患者的临床疗效较好,可一定程度改善凝血功能,使血管内皮损害减轻,为患者日后日常生活能力提供基础。

Objective To analyze the clinical prognosis of tirofiban hydrochloride and butylphthalide in-jection in patients with perforator artery cerebral infarction,in order to provide a reference for the clinical treat-ment of patients with perforated artery cerebral infarction.Methods A total of 86 patients with perforator artery cerebral infarction in Anyang District Hospital were selected for prospective study.They were divided into a con-trol group(43 cases)and a study group(43 cases)with a method of random number table.The control group was treated with butylphthalide injection,while the study group was treated with tirofiban hydrochloride combined with butylphthalide injection.The therapeutic cycle of both groups was 2 weeks.The clinical effect of the two groups was compared:D-dimer,prothrombin time,and fibrinogen level before and after 2 weeks of treatment;cystatin C and homocysteine before and after 1 week and 2 weeks of treatment;modified rankin scale(mRS)and barthel in-dex(BI)after 1 and 2 weeks of treatment.Results After clinical treatment,there were 33 and 40 clinically effec-tive patients in the control group and the study group,respectively,accounting for 77%and 93%.There were more effective patients in the study group than in the control group(χ^(2)=4.440,P=0.035).After 2 weeks of treatment,both groups showed lower D-dimer,fibrinogen than those before the treatment,and the decrease was more pronounced in the study group than that in the control group(t=27.371,6.088,all P<0.05),Prothrombin time was prolonged in both groups,and the prolongation in the study group was more pronounced than that in the control group(t=2.463,P<0.05).After 1 and 2 weeks of treatment,both groups showed lower cystatin C and homocysteine than those before the treatment,and the decrease in the study group was more significant than that in the control group(t=3.026,3.936,6.204,8.381,all P<0.05).After 2 weeks of treatment,both groups showed the decreased mRS scores and elevated BI scores compared to those treated 1 week,and the differences in mRS scores and BI scores of the study group were more significant than those of the control group(t=10.705,P<0.05;t=12.500,P<0.05).Conclusion Tirofiban hydrochloride combined with butylphthalein injection has a good clinical effect in the treatment of patients with perforator artery cerebral infarction,which can improve coagulation function to a certain extent,reduce vascular endothelial damage,and provide a basis for patients'future daily life.