替罗非班联合丁苯酞治疗急性进展性脑梗死的效果及对神经功能的影响

Effect of tirofiban combined with butylphthalide for acute progressive cerebral infarction and the impact on neurological function of patients

目的 观察替罗非班联合丁苯酞治疗急性进展性脑梗死(APCI)的临床效果及对神经功能的影响。方法 选取2020年3月—2023年3月高安市中医院收治的APCI患者66例,采用随机数字表法分为单药组(n=33)和研究组(n=33)。单药组患者予以丁苯酞氯化钠注射液,研究组患者在单药组基础上予以盐酸替罗非班氯化钠注射液,2组均连续用药21 d。比较2组临床疗效,用药前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力评定量表(ADL)评分、血小板计数(PLT)及不良反应。结果 研究组治疗总有效率高于单药组(96.97%vs.75.76%,χ^(2)=4.632,P=0.031)。用药21 d后,2组NIHSS评分低于用药前,ADL评分高于用药前,且研究组降低/升高幅度大于单药组(P均<0.01),2组治疗前后PLT比较差异无统计学意义(P>0.05)。单药组与研究组不良反应总发生率比较,差异无统计学意义(9.09%vs.6.06%,P=1.000)。结论 替罗非班联合丁苯酞治疗APCI的疗效确切,可显著减轻患者神经功能损伤,增强其日常生活活动能力,且不会对其血小板功能造成影响,安全性较高。

Objective To observe the effect of tirofiban combined with butylphthalide for APCI and the impact on neurological function of patients.Methods A total of 66 cases of APCI patients were selected from March 2020 to March 2023 in Gaoan Traditional Chinese Medicine Hospital,and they were divided into the single group(n=33) and the study group(n=33).Patients in the single group were given butylphthalide and sodium chloride injection,and patients in the study group were given tirofiban hydrochloride and sodium chloride injection on the basis of the single group,both groups were persistently treated for 21 days.Clinical efficacy,NIHSS score,ADL score,PLT before and after medication,incidence of adverse reactions were compared between the two groups.Results Total effective rate of the study group was higher than that in the single group(96.97% vs.75.76%,χ^(2)=4.632,P=0.031).After 21 days of medication,NIHSS scores of the two groups were lower than those before medication,ADL scores were higher than those before medication,and the decrease/increase in study group was greater than the single group(P<0.01),there was no significant difference in PLT between the two groups before and after treatment(P>0.05).There was no significant difference of the incidence of adverse reaction between the single group and the study group(9.09% vs.6.06%,P=1.000).Conclusion Tirofiban combined with butylphthalide are effective in the treatment of APCI,which can significantly reduce the neurological impairment of patients,and enhance their activities of daily living,without affecting their platelet function,and with higher safety.