替罗非班在脑梗死不同时期的安全性及对血小板活化的影响  

Safety of tirofiban in different periods of cerebral infarction and its effect on platelet activation

作　　者：杨直堂[1] 苏进营[1] 刘志军[1] 王琮民[1] 王友明[1] 盛学文[1] 刘保国[1] YANG Zhitang;SU Jinying;LIU Zhijun;WANG Congmin;WANG Youming;SHENG Xuewen;LIU Baoguo(The Affiliated Hospital of Hebei Engineering University,Handan 056002,China)

机构地区：[1]河北工程大学附属医院,河北邯郸056002

出　　处：《中国实用神经疾病杂志》2018年第20期2217-2221,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河北省卫计委重点科技研究计划(编号:1120140113)

摘　　要：目的探讨替罗非班在脑梗死不同时期的安全性及对血小板活化的影响。方法 120例脑梗死患者被随机分为脑梗死急性期组、脑梗死亚急性期组和对照组。对照组接受阿司匹林+胞二磷胆碱治疗,脑梗死急性期及亚急性期组接受72h的替罗非班+胞二磷胆碱治疗后,再继续行对照组治疗方案。各组分别于替罗非班治疗前及治疗后,行血小板计数、血尿、便血及血浆凝血酶原时间(PT)检查,同时采用NIHSS评分进行神经功能评定,采用ELISE检测P选择素表达水平,于治疗后第2天行头颅CT检查。结果在替罗非班治疗结束后,脑梗死急性期组和对照组均未见血尿、便血及颅内出血,3组血小板计数及PT均差异无统计学意义(P>0.05)。脑梗死急性期组NIHSS评分及P选择素均较亚急性期组及对照组明显降低,差异有统计学意义(P<0.05)。结论替罗非班在脑梗死急性期及亚急性期应用是安全的,能降低血小板的活化,且在脑梗死急性期具有治疗作用。Objective To investigate the safety of tirofiban in different periods of cerebral infarction and its effect on platelet activation.Methods 120 patients with cerebral infarction were randomly divided into acute stage group,subacute stage group and control group.The control group received aspirin+citicoline treatment,and acute stage group and subacute stage group received 72 hours of tirofiban+citicoline treatment,and then continued the treatment control group.Platelet count,hematuria,blood in the stool and plasma prothrombin time(PT)were measured before and after treatment with tirofiban.The NIHSS score was used for neurological assessment,and the expression level of P selectin was detected by ELISE.Head CT examination was performed on the 2nd day after treatment.Results After treatment with tirofiban,there was no hematuria,blood in the stool and intracranial hemorrhage in the acute phase and control group.There was no significant difference in platelet count and PT between the three groups(P>0.05).The NIHSS score and p-selectin in the acute phase of cerebral infarction were significantly lower than those in the subacute group and the control group,and the difference was statistically significant(P<0.05).Conclusion Tirofiban is safe in acute and subacute phase of cerebral infarction,can reduce platelet activation,and has a therapeutic effect in the acute phase of cerebral infarction.

关 键 词：脑梗死 急性期 亚急性期 替罗非班 安全性 血小板活化 

分 类 号：R743.33[医药卫生—神经病学与精神病学]