替罗非班治疗合并高胆固醇血症和高低密度脂蛋白胆固醇血症的急性脑梗死患者的疗效

Efficacy of tirofiban in treating acute cerebral infarction patients with hypercholesterolemia and high low density lipoprotein cholesterol

目的 观察替罗非班治疗合并高胆固醇血症和高LDL-C血症的急性脑梗死患者的疗效。方法 回顾性分析190例急性脑梗死患者的临床资料;其中,应用替罗非班治疗102例(观察组),常规应用阿司匹林和氯吡格雷治疗88例(对照组)。比较两组患者入院时(T0)、治疗48 h(T1)和治疗7 d(T2)以及不同TC和LDL-C水平患者的美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数。观察治疗7 d内不良反应发生情况。结果 T1和T2时,两组NIHSS评分均低于T0,且观察组低于对照组(P<0.05),两组Barthel指数均高于T0,且观察组高于对照组(P<0.05)。T0、T1和T2时,TC>5.7 mmol/L且LDL-C≥3.6 mmol/L患者的NIHSS评分均高于血脂水平正常和TC>5.7 mmol/L或LDL-C≥3.6 mmol/L患者,Barthel指数均低于血脂水平正常和TC>5.7 mmol/L或LDL-C≥3.6 mmol/L患者(P<0.05);T1和T2时,不同TC和LDL-C水平患者NIHSS评分均低于T0(P<0.05)。治疗7 d内两组患者均未见明显不良反应。结论 替罗非班可有效改善合并高胆固醇血症和高LDL-C血症的急性脑梗死患者的预后,且不增加出血风险。

Objective To observe the efficacy of tirofiban in treating acute cerebral infarction patients with hypercholesterolemia and high low-density lipoprotein cholesterol(LDL-C).Methods The clinical data of 190 patients with acute cerebral infarction were retrospectively analyzed,of whom 102 cases were treated with tirofiban(group A)and 88 cases were treated with aspirin and clopidogrel routinely(group C).National Institutes of Health Stroke Scale(NIHSS)score and Barthel index between the two groups and in the patients with different levels of total cholesterol(TC)and LDL-C were compared at the time points of admission(TO),48 hours(T1)and 7 days(T2)after treatment.The adverse reaction within 7 days of treatment was observed.Results At T1 and T2,the NIHSS score was lower,while Barthel index was higher than those at To in both groups(P<0.05),which changed more obviously in group A(P<0.05).The NIHSS score of the patients with TC>5.7 mmol/L and LDL-C≥3.6 mmol/L was higher,while Barthel index was lower than that of the patients with normal blood lipid levels and TC>5.7 mmol/L or LDL-C≥3.6 mmol/L at each time point(P<0.05).At T1 and T2,the NIHSS score of the patients with different TC and LDL-C levels was lower than that at T0(P<0.05).No obvious adverse reaction with in 7 days of treatment was observed in the two groups.Conclusion Tirofiban in the treatment of acute cerebral infarction patients with hypercholesterolemia and high LDL-C can improve the prognosis without increasing the risk of bleeding.