替罗非班治疗静脉溶栓后早期神经功能恶化脑梗死的临床观察

Clinical effect of tirofiban in the treatment of early neurological deterioration after intravenous thrombolysis in patients with cerebral infarction

目的研究替罗非班治疗静脉溶栓后早期神经功能恶化(END)脑梗死的临床效果。方法队列研究。抽取2021年1月至2021年12月河南宏力医院收治的静脉溶栓后END脑梗死患者72例,按照随机数字表法分为阿司匹林组和替罗非班组,每组36例。阿司匹林组给予阿司匹林治疗,替罗非班组给予替罗非班治疗。比较两组疗效、白细胞介素-6(IL-6)水平、C反应蛋白(CRP)水平、美国国立卫生院卒中量表(NIHSS)评分、血小板聚集情况及不良反应发生率。结果替罗非班组总有效率(94.44%,34/36)高于阿司匹林组(75.00%,27/36),P<0.05。治疗后,替罗非班组IL-6、CRP水平低于阿司匹林组(P<0.05);治疗后,替罗非班组NIHSS评分低于阿司匹林组(P<0.05);治疗后,替罗非班组血小板聚集率、血小板黏附率低于阿司匹林组(P<0.05)。替罗非班组不良反应发生率(13.89%,5/36)与阿司匹林组(8.33%,3/36)比较差异未见统计学意义(P>0.05)。结论替罗非班对静脉溶栓后END脑梗死患者的效果治疗较好,可减轻炎症反应,减少血小板聚集,且安全性良好。

Objective To investigate the clinical effect of tirofiban in the treatment of early neurological deterioration after intravenous thrombolysis in patients with cerebral infarction.Methods Seventy-two patients with END after intravenous thrombolysis for cerebral infarction admitted to Henan Hon liv Hospital from January 2021 to December 2021 were selected,and they were divided into an aspirin group and a tirofiban group by random number table method,with 36 cases in each group.The aspirin group was treated with aspirin,while the tirofiban group received tirofiban for treatment.The curative effect,levels of interleukin-6(IL-6)and C-reactive protein(CRP),neurological function assessed by National Institute of Health stroke scale(NIHSS)score,platelet aggregation and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the tirofiban group(94.44%,34/36)was higher than that of the aspirin group(75.00%,27/36),P<0.05.After treatment,the tirofiban group had lower levels of IL-6 and CRP compared with the aspirin group(P<0.05).After treatment,NIHSS score of the tirofiban group was lower than that of the aspirin group(P<0.05).After treatment,the platelet aggregation rate and platelet adhesion rate in the tirofiban group were lower than those in the aspirin group(P<0.05).There was no significant difference in the incidence of adverse reactions between the tirofiban group(13.89%,5/36)and the aspirin group(8.33%,3/36),P>0.05.Conclusions Tirofiban has good effects in the treatment of END after intravenous thrombolysis for cerebral infarction,which can reduce inflammation and decrease platelet aggregation,with good safety.