替罗非班配合尿激酶静脉溶栓治疗觉醒型进展性卒中患者的效果及对血小板活性与聚集功能、凝血因子的影响  

The effect of tirofiban combined with intravenous thrombolysis in the treatment of patients with awakening progressive stroke and its influence on platelet activity,aggregation function and coagulation factor

作　　者：郭医杰 刘亚林 孔咏梅 张晓林 钱丽花 Guo Yijie;Liu Yalin;Kong Yongmei;Zhang Xiaolin;Qian Lihua(Department of Neurology,the Third Hospital of Xingtai,Hebei 054000,China)

机构地区：[1]邢台市第三医院神经内科四病区,河北054000

出　　处：《脑与神经疾病杂志》2021年第10期600-604,共5页Journal of Brain and Nervous Diseases

基　　金：邢台市科技计划项目(2017ZC077)。

摘　　要：目的探究替罗非班配合尿激酶静脉溶栓在觉醒型进展性卒中患者中的应用价值。方法选取邢台市第三医院院神经内科2017年12月至2019年12月觉醒型进展性卒中患者82例进行前瞻性研究,随机分组,各41例。两组均给予相同基础治疗,对照组给予静脉溶栓治疗,研究组给予替罗非班配合静脉溶栓治疗。比较两组治疗效果、治疗前后血小板活性与聚集功能指标[血小板CD62p、CD63、血小板黏附性(PAdT)、血小板聚集率(PAgT)]、凝血因子[凝血因子(FⅫ)、纤维蛋白原(FIB)、血浆中纤溶酶原(PLG)]、神经相关因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)],并随访30 d,比较两组预后[Rankin修订量表评分(mRS)]。结果研究组总有效率92.68%(38/41)高于对照组75.61%(31/41)(P<0.05);研究组治疗后1d、7d、14 d血小板CD62p、CD63、PAdT、PAgT低于对照组(P<0.05);治疗后1d、7d、14d研究组PLG较对照组高,FⅫ、FIB较对照组低(P<0.05);研究组治疗后7d、14 d血清BDNF、NGF高于对照组,NSE低于对照组(P<0.05);随访30 d,研究组mRS评分0~2分比例87.80%(36/41)优于对照组68.29%(28/41)(P<0.05)。结论替罗非班配合静脉溶栓通过改善血小板活性与聚集功能,调节凝血因子表达,有助于增强治疗效果,修复觉醒型进展性卒中患者受损神经功能,进而有效促进预后改善。Objective To explore the application value of tirofiban combined with intravenous thrombolysis in patients with awakening progressive stroke.Methods A prospective study was conducted on 82 patients with awakening progressive stroke in our hospital from December 2017 to December 2019,and randomized groups of 41 cases in each case.Both groups were given the same basic treatment,the control group was given intravenous thrombolysis,and the study group was given tirofiban combined with intravenous thrombolysis.Comparison of the treatment effect,platelet activity and aggregation function indicators before and after treatment[platelet CD62 p,CD63,platelet adhesion(PAdT),platelet aggregation rate(PAgT)],coagulation factor[coagulation factor(FⅫ),fibrinogen(FIB),plasma plasminogen(PLG)],nerve-related factors[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),neuron-specific enolase(NSE)],and followed up for 30 d,To compare the prognosis of the two groups[Rankin Revised Scale Score(mRS)].Results The total effective rate of the study group was 92.68%(38/41)higher than that of the control group 75.61%(31/41)(P<0.05);the platelet CD62 p,CD63,PAdT,and PAgT of the study group were low at 1 d,7 d,and 14 d after treatment In the control group(P<0.05);PLG in the study group was higher than that in the control group at 1 d,7 d,and 14 d after treatment,and FⅫand FIB were lower than in the control group(P<0.05);Serum in the study group was 7 d,14 d after treatment BDNF and NGF were higher than the control group,and NSE was lower than the control group(P<0.05);after30 days of follow-up,87.80%(36/41)of the study group’s mRS score was better than the control group 68.29%(28/41)(P<0.05).Conclusion Tirofiban combined with intravenous thrombolysis can improve the platelet activity and aggregation function and regulate the expression of coagulation factors,which can help to enhance the therapeutic effect and repair the damaged nerve function of patients with awakening progressive stroke.Thereby effectively promoting the i

关 键 词：替罗非班 尿激酶静脉溶栓 觉醒型进展性卒中 血小板活性与聚集 凝血因子 不良事件 

分 类 号：R743.32[医药卫生—神经病学与精神病学]