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替罗非班用于急性缺血性脑卒中早期神经功能恶化的疗效分析
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| 篇名： | 替罗非班用于急性缺血性脑卒中早期神经功能恶化的疗效分析 |
| TITLE： | Analysis of the clinical effect of tirofiban in the treatment of early neurological deterioration in patients with acute ischemic stroke |
| 摘要： | 目的 探讨替罗非班用于急性缺血性脑卒中早期神经功能恶化患者的有效性及安全性。方法选取2022年1月－2023年12月入住长治医学院附属和济医院神经内科治疗的急性缺血性脑卒中早期神经功能恶化患者126例为对象，按随机数字表法分为观察组和对照组，各63例。所有患者均接受降脂、降压等标准化治疗，对照组患者在标准化治疗的基础上口服阿司匹林肠溶片100mg+硫酸氢氯吡格雷片75mg（每天1次，连续14d）；观察组患者在标准化治疗的基础上加用盐酸替罗非班氯化钠注射液[先以0.40μg/（kg·min）静脉输注30min，再以0.10μg/（kg·min）连续静脉输注47.5h]，后口服阿司匹林肠溶片100mg+硫酸氢氯吡格雷片75mg（每天1次，连续14d）。比较两组患者的临床疗效，治疗前后的美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表（mRS）评分和血液流变学指标，并记录不良反应发生情况。结果观察组患者的总有效率（87.30%）显著高于对照组（71.43%）（P＜0.05）；两组患者治疗后1、7、14d的NIHSS评分，治疗后90d的mRS评分，以及治疗后14d的血小板聚集率、全血黏度、血浆黏度、纤维蛋白原均较同组治疗前显著降低，且观察组显著低于同期对照组（P＜0.05）；两组患者恶心、头痛、发热、胃肠道出血、口鼻黏膜出血、血小板减少的总不良反应发生率均为28.57%，差异无统计学意义（P＞0.05）。结论对于急性缺血性脑卒中早期神经功能恶化患者，加用替罗非班可加快神经功能恢复，改善血液高黏度、血小板聚集状态及患者预后，且安全性良好。 |
| ABSTRACT： | OBJECTIVE To investigate the efficacy and safety of tirofiban for early neurological deterioration in patients with acute ischemic stroke. METHODS A total of 126 patients with early neurological deterioration of acute ischemic stroke who were admitted to the Department of Neurology， Heji Hospital Affiliated to Changzhi Medical College from January 2022 to December 2023 were selected and divided into observation group and control group according to random number table method， with 63 cases in each group. All patients received standardized treatment such as lipid-lowering and blood pressure-lowering therapy. Based on the standard treatment， patients in the control group additionally took Aspirin enteric-coated tablets 100 mg+Clopidogrel bisulfate tablets 75 mg orally （once a day， for 14 consecutive days）. The patients in the observation group received Tirofiban hydrochloride and sodium chloride injection based on the standardized treatment [first intravenous infusion of 0.40 μg/（kg·min） for 30 min， and then continuous intravenous infusion of 0.10 μg/（kg·min） for 47.5 h]； subsequently， patients were given Aspirin enteric-coated tablets （100 mg） and Clopidogrel bisulfate tablets （75 mg） once a day for 14 consecutive days. The clinical efficacy， the National Institutes of Health Stroke Scale （NIHSS） score， modified Rankin Scale （mRS） score， and hemorheological indexes before and after treatment were compared between the two groups， and the adverse reactions were recorded. RESULTS The total effective rate （87.30%） of the observation group was significantly higher than that of the control group （71.43%） （P＜0.05）. NIHSS scores of the two groups at 1st， 7th and 14th day after treatment， the mRS score at 90th day after treatment， and the platelet aggregation rate， whole blood viscosity， plasma viscosity and fibrinogen at 14th day after treatment were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group at the same period （P＜0.05）. The total incidences of adverse reactions such as nausea， headache， fever， gastrointestinal bleeding， oral and nasal mucosal bleeding and thrombocytopenia in both groups of patients were 28.57% respectively， with no statistically significant difference （P＞0.05）. CONCLUSIONS For patients with early neurological deterioration in acute ischemic stroke， the addition of tirofiban can accelerate the recovery of neurological function， improve blood hyperviscosity and platelet aggregation， and improve the prognosis of patients with good safety. |
| 期刊： | 2025年第36卷第10期 |
| 作者： | 李晓慧；李晓民；魏明阳；郭慧敏；王琛；张建斌；赵志强 |
| AUTHORS： | LI Xiaohui，LI Xiaomin，WEI Mingyang，GUO Huimin，WANG Chen，ZHANG Jianbin，ZHAO Zhiqiang |
| 关键字： | 替罗非班；急性缺血性脑卒中；早期神经功能恶化；临床效果 |
| KEYWORDS： | tirofiban； acute ischemic stroke； early neurological deterioration； clinical effect |
| 阅读数： | 10 次 |
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