替罗非班辅助阿司匹林肠溶片与氯吡格雷对急性脑梗死的治疗效果研究

Study on the therapeutic effect of tirofiban assisted aspirin enteric coated tablets and clopidogrel on acute cerebral infarction

目的:研究替罗非班辅助阿司匹林肠溶片和氯吡格雷治疗急性脑梗死(Acute cerebral infarction,ACI)的临床疗效。方法:收集2020年7月至2023年2月期间本院收治的83例ACI患者的临床资料,进行回顾性分析。根据治疗方案的不同,将患者分为对照组(氯吡格雷+阿司匹林肠溶片治疗,39例)和观察组(替罗非班+氯吡格雷+阿司匹林肠溶片,44例)。分析比较两组治疗前和治疗3m后的脑血管血流动力学指标、神经功能、日常活动能力和治疗期间的不良反应。其中脑血管血流动力学用平均血流速度(Vm)、搏动指数(Pulsatility Index,PI)、阻力指数(Resistance Index,RI)表示,神经功能用中国卒中量表(China Stroke Scale,CSS)评分表示,日常活动能力用日常生活能力量表(Barthel Index,BI)评分表示。结果:治疗后,观察组的Vm比对照组显著提高,PI及RI指数均显著低于对照组(P<0.05)。治疗后,观察组的CSS评分显著低于对照组,BI评分显著高于对照组(P<0.05)。两组的不良反应无显著差异(P<0.05)。结论:替罗非班辅助阿司匹林肠溶片+氯吡格雷治疗方案能改善ACI患者脑部血流量情况,促进神经功能恢复,提高日常生活能力,且安全性较好。

Objective:To study on the clinical efficacy of tirofiban assisted aspirin enteric coated tablets and clopidogrel in the treatment of acute cerebral infarction(ACI).Methods:Collected during July 2020 to February 2023 in our hospital were the clinical data of 83 patients with ACI were retrospectively analyzed.According to different treatment regimens,the patients were divided into control group(clopidogrel+aspirin enteric-coated tablets,39 cases)and observation group(tirofiban+clopidogrel+aspirin enteric-coated tablets,44 cases).Analyze and compare the cerebral vascular hemodynamic indicators,neurological function,daily activity ability,and adverse reactions during treatment between two groups before and after 3 months of treatment.Among them,cerebral vascular hemodynamics are represented by mean blood flow velocity(Vm),pulsatility index(PI),and resistance index(RI),neurological function is represented by the China Stroke Scale(CSS)score,and daily activity ability is represented by the Barthel Index(BI)score..Results:After treatment,Vm in observation group was significantly higher than that in control group,PI and RI index were significantly lower than that in control group(P<0.05).After treatment,the CSS score of the observation group was significantly lower than that of the control group,and the BI score was significantly higher than that of the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P<0.05).Conclusion:The combination therapy of tirofiban,aspirin enteric coated tablets,and clopidogrel can improve cerebral blood flow in ACI patients,promotes neurological recovery,and improves daily living ability in patients with ACI,and has a better safety profile.