替罗非班桥接拜阿司匹林和氯吡格雷双抗对超时间窗急性脑梗死患者血小板活化的影响研究  

Effect of tirofiban bridging bayaspirin and clopidogrel on platelet activation in patients with acute cerebral infarction over time window

作　　者：朱学芳[1] 朱建建[1] 韩鲜艳 ZHU Xue-fang;ZHU Jian-jian;HAN Xian-yan(Department of Neurology,Rugao People's Hospital,Rugao 226500,China)

机构地区：[1]如皋市人民医院神经内科,江苏如皋226500

出　　处：《哈尔滨医科大学学报》2022年第4期363-367,共5页Journal of Harbin Medical University

摘　　要：目的探讨替罗非班桥接拜阿司匹林和氯吡格雷双抗对超时间窗急性脑梗死患者血小板活化的影响。方法选择2020年7月~2021年3月本院收治的78例超时间窗急性脑梗死患者为研究对象,依照随机数字表法分为治疗组与对照组,每组39例。对照组给予拜阿司匹林和氯吡格雷双抗治疗,治疗组给予替罗非班桥接拜阿司匹林和氯吡格雷双抗治疗,持续治疗2周。比较治疗前(T0)、治疗48 h后(T1)、治疗2周后(T2)两组美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分、血清血小板表面α颗粒膜糖蛋白CD62p、血小板活化因子(platelet activating factor,PAF)水平,治疗3个月后,比较两组近期预后,比较治疗期间两组出血事件发生情况及治疗3个月内死亡情况。结果T2时刻两组NIHSS评分、血清CD62p、PAF水平低于T0、T1时刻(P<0.05),T1时刻两组NIHSS评分、血清CD62p、PAF水平低于T0时刻低(P<0.05),且T1、T2时刻治疗组NIHSS评分、血清CD62p、PAF水平均低于对照组(P<0.05);T2时刻两组MoCA评分高于T0、T1时刻(P<0.05),T1时刻两组MoCA评分高于T0时刻(P<0.05),且T1、T2时刻治疗组MoCA评分高于对照组(P<0.05);治疗3个月后,预后良好率治疗组(76.92%)高于对照组(53.85%),P<0.05;治疗期间两组出血事件发生率比较,差异无统计学意义(P>0.05);治疗3个月内,两组各有1例死亡。结论替罗非班桥接拜阿司匹林和氯吡格雷双抗可改善超时间窗急性脑梗死患者的神经功能及认知功能,减少血小板活化,改善近期预后,安全可靠。Objective To investigate the effect of tirofiban bridging bayaspirin and clopidogrel on platelet activation in patients with acute cerebral infarction over time window.Methods A total of 78 patients with acute cerebral infarction over time window admitted in our hospital from July 2020 to March 2021 were selected.According to the random number table method,they were divided into treatment group and control group,with 39 cases in each group.The control group was treated with bayaspirin and clopidogrel for 2 weeks,and the treatment group was treated with tirofiban bridged by bayaspirin and clopidogrel for 2 weeks.Before treatment(T0),after 48 hours of treatment(T1),and after 2 weeks of treatment(T2),the National Institutes of Health Stroke Scale(NIHSS)score,Montreal Cognitive Assessment Scale(MoCA)score,serumαgranular membrane glycoprotein CD62 p and platelet activating factor(PAF)levels were compared.After 3 months of treatment,the short-term prognosis of the two groups was compared.The occurrence of bleeding events during the treatment period and the deaths within 3 months of treatment were compared between the two groups.Results The NIHSS score,serum CD62 p and PAF levels of the two groups at T2 were lower than those at T0 and T1(P<0.05).The NIHSS score,serum CD62 p,and PAF levels of the two groups at T1 were lower than those at T0(P<0.05),the NIHSS score,serum CD62 P and PAF levels of the treatment group at T1 and T2 were lower than those of the control group(P<0.05).The MoCA scores of the two groups at T2 were higher than those at T0 and T1(P<0.05),the MoCA scores of the two groups at T1 were higher than T0(P<0.05),and the MoCA scores of the treatment group at T1 and T2 were higher than those of the control group(P<0.05).After 3 months of treatment,the good prognosis rate of the treatment group(76.92%)was higher than control group(53.85%)(P<0.05).There was no significant difference in the incidence of bleeding events between the two groups during treatment(P>0.05).Within 3 months of treatment,1 case died in e

关 键 词：替罗非班 拜阿司匹林 氯吡格雷 急性脑梗死 血小板活化 安全性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]