阿替普酶联合替罗非班治疗急性脑梗死的效果及对患者神经功能的影响

Therapeutic effect of ateplase combined with tirofiban on acute cerebral infarction and its influence on neurological function

目的探讨阿替普酶(rt-PA)联合替罗非班对急性脑梗死(ACI)的治疗效果及对患者神经功能的影响。方法队列研究。抽取2021年10月至2023年12月咸阳市第一人民医院收治的100例ACI患者,采用信封法将其随机分为对照组与研究组,每组50例。对照组采用rt-PA治疗,研究组采用rt-PA联合替罗非班治疗。记录并比较两组治疗前后神经功能[美国国立卫生院卒中量表(NIHSS)评分]、神经因子[神经生长因子(NGF)、脑源性神经营养因子(BDNF)]水平,比较两组治疗过程中出血事件发生情况。结果治疗前,两组NIHSS评分比较差异未见统计学意义(P>0.05);治疗后,两组NIHSS评分均低于治疗前,且研究组NIHSS评分低于对照组(P<0.05)。治疗前,两组NGF、BDNF比较差异未见统计学意义(P>0.05);治疗后,两组NGF、BDNF水平均高于治疗前,且研究组NGF、BDNF水平高于对照组(P<0.05)。研究组治疗过程中出血事件总发生率(10.00%,5/50)与对照组(6.00%,3/50)比较差异未见统计学意义(P>0.05)。结论rt-PA联合替罗非班治疗ACI效果显著,有利于改善患者神经因子相关指标,且安全性较高。

Objective To investigate the therapeutic effects of combination of ateplase,referred to as rt-PA,and tirofiban on acute cerebral infarction(ACI)and its influence on neurological function.Methods A total of 100 ACI patients admitted to the First People’s Hospital of Xianyang from October 2021 to December 2023 were selected for the cohort study.And they were randomly divided into a control group and a study group by envelope method,with 50 cases in each group.The control group was treated with rt-PA,and the study group was treated with rt-PA combined with tirofiban.The neurological function evaluated by American National Institutes of Health stroke scale(NIHSS)score and levels of neurotrophic factors,including nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF),were compared between the two groups before and after treatment.The occurrence of bleeding events during the treatment process of the two groups were compared.Results There was no significant difference in NIHSS scores between the two groups before treatment(P>0.05).After treatment,the NIHSS scores of both groups were lower than those before treatment,and the study group had lower NIHSS score compared with the control group(P<0.05).There was no significant difference in levels of NGF and BDNF between the two groups(P>0.05).After treatment,the levels of NGF and BDNF in both groups increased,and the levels of NGF and BDNF in the study group were higher than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of bleeding events between the study group(10.00%,5/50)and the control group(6.00%,3/50),P>0.05.Conclusions The combination of rt-PA and tirofiban has a significant effect in the treatment of ACI,which is beneficial for improving the neurotrophic factors.Moreover,this combined treatment regimen is safer.