替罗非班对超溶栓时间窗老年急性缺血性脑卒中患者的疗效分析  

Therapeutic effect of tirofiban in elderly acute ischemic stroke patients with hyperthrombolysis window

作　　者：李永芳[1] 刘华[2] 李艾帆[1] 崔传举[1] 王焕婷 燕燕[1] Li Yongfang;Liu Hua;Li Aifan;Cui Chuanju;Wang Huanting;Yan Yan(Department of Neurology,Zhengzhou First People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第一人民医院神经内科,450000 [2]郑州大学基础医学实验中心

出　　处：《中华老年心脑血管病杂志》2021年第4期399-402,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190983)。

摘　　要：目的探讨急性缺血性脑卒中(acute ischemic stroke,AIS)超溶栓时间窗老年患者应用替罗非班的有效性及安全性。方法选取2019年10月~2020年2月郑州市第一人民医院神经内科收治的超溶栓时间窗老年AIS患者150例,随机分为观察组75例和对照组75例,对照组给予常规药物治疗,观察组在常规药物治疗的基础上应用替罗非班治疗。采用美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)和改良的Rankin量表(mRS)评估患者治疗效果。观察2组有效率,预后良好率以及不良反应情况。结果治疗前2组NIHSS评分和mRS评分比较,无统计学差异[(9.06±4.65)分vs(9.64±3.91)分,(3.16±1.37)分vs(2.89±1.23)分,P>0.05]。2组治疗14 d NIHSS评分、mRS评分及治疗3个月mRS评分明显低于治疗前(P<0.05,P<0.01),且观察组治疗14 d NIHSS评分、mRS评分及治疗3个月mRS评分明显低于对照组[(2.85±1.02)分vs(3.41±1.14)分,(1.54±1.28)分vs(2.01±1.11)分,(0.51±0.38)分vs(1.47±0.57)分,P=0.000]。观察组治疗14 d有效率、预后良好率和治疗3个月预后良好率明显高于对照组(93.3%vs 80.0%,P=0.027;54.7%vs 37.3%,P=0.035;73.3%vs 62.7%,P=0.014)。2组不良反应发生率比较,无统计学差异(P=0.749)。结论超溶栓时间窗老年AIS患者静脉给予替罗非班能有效减轻神经功能缺损,改善老年AIS患者的预后,且颅内及全身出血风险小。Objective To study the efficacy and safety of tirofiban in elderly acute ischemic stroke(AIS) patients with hyperthrombolysis window.Methods One hundred and fifty elderly AIS patients with hyperthrombolysis window admitted to Zhengzhou First People’s Hospital from October 2019 to February 2020 were randomly divided into observation group(n=75) and control group(n=75).The patients in control group received conventional drug therapy and those in observation group received conventional drug therapy+tirofiban therapy.The therapeutic effect of tirofiban in elderly AIS patients with hyperthrombolysis window was assessed according to their national institute of health stroke scale(NIHSS) score and modified Rankin scale(mRS) score.The therapeutic effect, good and poor outcomes in two groups were recorded.Results No significant difference was detected in NIHSS score and mRS score between the two groups before treatment(9.06±4.65 vs 9.64±3.91,3.16±1.37 vs 2.89±1.23,P>0.05).The NIHSS score and mRS score after 14 days of treatment and the mRS score after 3 months of treatment were significantly lower than those before treatment in two groups(P<0.05,P<0.01) and in observation group than in control group(2.85±1.02 vs 3.41±1.14,1.54±1.28 vs 2.01±1.11,0.51±0.38 vs 1.47±0.57,P=0.000).The therapeutic efficiency and good outcome rate after 14 days and 3 months of treatment were significantly higher in observation group than in control group(93.3% vs 80.0%,P=0.027;54.7% vs 37.3%,P=0.035;73.3% vs 62.7%,P=0.014).No significant difference was detected in adverse reaction rate between the two groups(P>0.05).Conclusion Tirofiban can effectively alleviate the neurological deficit, improve the outcome, and reduce the risk of intracranial and general hemorrhage in elderly AIS patients with hyperthrombolysis window.

关 键 词：卒中 组织型纤溶酶原激活物 血小板聚集抑制剂 出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]