替罗非班在缺血性进展性卒中的疗效观察

Observation on efficacy of tirofiban in patients with ischemic progressive stroke

目的观察盐酸替罗非班对缺血性进展性卒中的疗效。方法对300例符合进展性缺血性卒中标准的患者分成常规治疗组和替罗非班治疗组,其中常规治疗组给予强化抗血小板及强化降脂药物(PA2S方案,即普罗布考0. 5 g 2/d+硫酸氢氯吡格雷75 mg 1/d+阿司匹林100mg 1/d+阿托伐他汀40 mg 1/d),替罗非班组在PA2S方案的基础上,加用替罗非班,治疗后3天、1月及半年分别随访两组患者美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分,比较其组间差异。结果常规治疗组患者在治疗前、治疗3天、治疗1月及治疗半年时NIHSS评分分别为(11. 3±4. 2)分、(11. 5±4. 4)分、(8. 8±4. 1)分、(6. 1±4. 1)分;替罗非班组患者在治疗前、治疗3天、治疗1月及治疗半年时NIHSS评分分别为(11. 4±3. 9)分、(10. 8±3. 6)分、(7. 4±3. 2)分、(4. 4±3. 0)分。在治疗1月及半年时两组间有统计学差异(P <0. 01),替罗非班治疗优于常规治疗。结论盐酸替罗非班可改善进展性卒中患者神经功能缺损程度。

Objective To observe the efficacy of tirofiban in the treatment of ischemic progressive stroke.Methods 300 patients who met the diagnostic criteria of ischemic progressive stroke were divided into the control group and tirofiban group.Patients in the control group received treatment of PA2S regiment,i.e.,a combination of aspirin,clopidogrel,probucol and atorvastatin.Patients in the tirofiban group received extra tirofiban on the basis of PA2S therapy.National institute of health stroke scale(NIHSS)score was evaluated on patients in both group before the therapy and 3 days,1 month,6 months after the therapy respectively.Results For the control group,the average NIHSS score was 11.3±4.2,11.5±4.4,8.8±4.1,6.1±4.1 before therapy and at 3 days,1 month,6 months after the therapy.And for the tirofiban group,the average NIHSS score was 11.4±3.9,10.8±3.6,7.4±3.2,4.4±3.0 at the corresponding period respectively.There were statistical differences between the two groups in the period of 1 month and 6 months after treatment with P<0.001.Conclusions Tirofiban hydrochloride can improve the degree of neurological deficit and outcome in patients with ischemic progressive stroke.