替罗非班联合丁苯酞针剂治疗穿支动脉粥样硬化病的临床疗效和安全性  

Clinical efficacy and safety of tirofiban combined with butylphthalide injection in the treatment of perforator atherosclerosis

作　　者：喻志慧 马骏 陈建光 沈轲 YU Zhihui;MA Jun;CHEN Jianguang;SHEN Ke(Shaoxing Central Hospital,Shaoxing 312030,China)

机构地区：[1]绍兴市中心医院医共体总院,浙江绍兴312030

出　　处：《浙江实用医学》2022年第2期97-100,共4页Zhejiang Practical Medicine

摘　　要：目的 探讨替罗非班联合丁苯酞针剂治疗穿支动脉粥样硬化病(BAD)的临床疗效和安全性。方法选择浙江省绍兴市中心医院医共体总院2019年1月-2020年12月252例BAD患者,按照随机数字表法分为常规治疗(常规治疗组)、常规治疗+替罗非班治疗(替罗非班组)、常规治疗+替罗非班+丁苯酞针剂治疗(联合治疗组),每组84例。常规治疗组采用抗血小板聚集、抗动脉硬化、降压及降血糖等治疗;替罗非班组除常规治疗外采用替罗非班0.4μg/(kg·min)静脉滴注30分钟,后0.1μg/(kg·min)连续静注24~72小时。联合治疗组除上述治疗外,加用丁苯酞针剂25mg,2次/d,连用14天。观察并比较三组治疗前、治疗后2周、1个月及3个月NIHSS与mRS评分、临床疗效和不良反应。结果 (1)治疗后,每组各时间段与治疗前比较NIHSS评分均明显降低(P<0.05);常规治疗组治疗后1个月、3个月后,m RS评分低于治疗前(P<0.05),替罗非班组及联合治疗组治疗后2周、1个月及3个月mRS评分明显低于治疗前(P<0.05)。替罗非班组及联合治疗组各时间段NIHSS评分及mRS评分均明显低于常规治疗组(P<0.05),且联合用药组均低于替罗非班组(P<0.05)。(2)联合治疗组有效率(95.24%)高于替罗非班组(78.57%)和常规治疗组(64.29%)(P<0.05);替罗非班组有效率高于常规治疗组(P<0.05)。(3)三组恶心呕吐、肝功能异常等不良反应差异无统计学意义(P>0.05)。结论 对于BAD患者,替罗非班联合丁苯酞针剂是更好的治疗选择。Objective To investigate the efficacy and safety of tirofiban combined with butylphthalide injection in the treatment of perforating atherosclerosis(BAD).Methods A total of 252 patients with BAD were divided into usual treatment(conventional treatment group),conventional treatment+tirofiban(tirofiban),conventional treatment+tirofiban+butyrophthalide injection(combination treatment group),with 84 cases in each group.The conventional treatment group used antiplatelet aggregation,anti-arteriosclerosis,antihypertensive and hypoglycemic treatments;In addition to conventional treatment,tirofiban 0.4μg/(kg·min)intravenous infusion was used for 30 minutes,followed by 0.1ug/(kg·min)intravenous injection for 24~72 hours.In addition to the above treatment,the combination treatment group added 25mg of butyranide injection,2 times/d,for 14 days.NIHSS and mRS scores,clinical efficacy and adverse effects were observed and compared between the three groups before,2 weeks、1 month and 3 months after treatment.Results(1)Compared with the pre-treatment time period in each group,the NIHSS score was significantly reduced(P<0.05);The mRS scores were lower than those before treatment at 1 and 3 months in the usual treatment group(P<0.05),and significantly lower at 2 weeks,1 month and 3 months after treatment in the tirofiban and combination treatment groups(P<0.05).The NIHSS score and mRS score of tirofil and combination therapy group were significantly lower than those in the usual treatment group(P<0.05),The combination group was lower than that of tirofiban(P<0.05).(2)The effective rate of the combination treatment group(95.24%)was higher than that of the tirofiban group(78.57%)and the usual treatment group(64.29%)(P<0.05);The tirofitabin group was more effective than usual care(P<0.05).(3)There were no significant differences in adverse reactions such as nausea and vomiting and abnormal liver function between the three groups(P>0.05).Conclusion For patients with BAD,tirofiban combined with butylphthalide injection is a better t

关 键 词：穿支动脉粥样硬化病 替罗非班 丁苯酞针剂 

分 类 号：R743.3[医药卫生—神经病学与精神病学]