替罗非班与丁苯酞联合治疗对发病24 h内未行溶取栓治疗的急性缺血性脑卒中的疗效影响  

Effect of tirofiban combined with butylphthalide on moderate acute ischemic stroke without thrombolytic therapy within 24 hours after onset

作　　者：朱存良 易芳芳 谭若利[1] 张瑛瑛[1] 洪早云[1] 赵子攀[1] 颜艳 李长茂[1] ZHU Cun-liang;YI Fang-fang;TAN Ruo-li(Department of Neurology,Loudi Central Hospital,Loudi Hunan 417000,China)

机构地区：[1]娄底市中心医院神经内科,湖南娄底417000

出　　处：《临床和实验医学杂志》2023年第3期254-257,共4页Journal of Clinical and Experimental Medicine

基　　金：湖南省科技创新计划项目(编号:2020SK51602);娄底市科技局项目(娄财教指[2020]43号);“湘中青年人才”支持计划资金支持。

摘　　要：目的探讨替罗非班与丁苯酞联合治疗对发病24 h内未行溶取栓治疗的急性缺血性脑卒中(AIS)的疗效。方法前瞻性选取2020年3月至2022年3月娄底市中心医院收治的AIS患者69例,运用随机数字表法分为观察组34例与对照组35例。对照组给予替罗非班注射液,观察组在对照组基础上给予丁苯酞软胶囊。两组治疗周期14 d。比较两组治疗疗效,治疗前后NIHSS评分和改良Barthel指数评分、炎症因子和同型半胱氨酸(Hcy)水平变化。结果观察组患者总有效率为91.84%,高于对照组(73.47%),差异有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分较治疗前降低,而改良Barthel指数评分较治疗前升高,观察组患者NIHSS评分为(6.08±1.54)分,低于对照组[(8.72±1.73)分],而改良Barthel指数评分为(68.81±6.51)分,高于对照组[(57.73±5.69)分],差异均有统计学意义(P<0.05)。治疗后,两组患者血清hs-CRP和IL-6水平较治疗前降低,且观察组血清hs-CRP和IL-6为(4.21±1.28)mg/L、(18.84±4.25)ng/L,低于对照组[(5.68±1.19)mg/L和(32.14±6.64)ng/L],差异均有统计学意义(P<0.05)。治疗后,两组患者血清Hcy水平较治疗前降低,且观察组血清Hcy为(7.98±2.15)μmol/L,低于对照组[(10.74±2.53)μmol/L],差异有统计学意义(P<0.05)。结论替罗非班与丁苯酞联合治疗对发病24 h内未行溶取栓治疗的AIS患者疗效显著,可减轻细胞炎症反应,降低Hcy水平。Objective To investigate the efficacy of tirofiban combined with butylphthalide in the treatment of acute ischemic stroke(AIS)without thrombolytic therapy within 24 hours of onset.Methods The 69 patients with AIS in Loudi Central Hospital from March 2020 to March 2022 divided 34 cases observation group and 35 cases control group.The control group was given tirofiban injection,and the observation group was given butylphthalide soft capsule basis control group.The treatment period of the two groups was 14 days.The therapeutic effects of two groups were compared,and the changes of NIHSS score and modified Barthel index score,inflammatory factors,homocysteine(Hcy)levels before and after treatment were compared.Results The observation group total effective rate was 91.84%,which was higher control group(73.47%),the difference was statistically significant(P<0.05).After treatment,NIHSS score of two groups were lower before treatment,while the modified Barthel index score were higher before treatment,and NIHSS scores in the observation group were(6.08±1.54)points,which were lower than those in the control group[(8.72±1.73)points],while the modified Barthel index scores were(68.81±6.51)points,which were higher those in the control group[(57.73±5.69)points],the differences were statistically significant(P<0.05).After treatment,serum hs-CRP and IL-6 of two groups were lower than before treatment,serum hs-CRP and IL-6 in the observation group were(4.21±1.28)mg/L,(18.84±4.25)ng/L,which were lower than those in the control group[(5.68±1.19)mg/L and(32.14±6.64)ng/L],the differences were statistically significant(P<0.05).After treatment,serum Hcy of two groups were lower than before treatment,serum Hcy in the observation group was(7.98±2.15)μmol/L,which was lower than that in the control group[(10.74±2.53)μmol/L],the difference was statistically significant(P<0.05).Conclusion The combined treatment of tirofiban and butylphthalide has a significant effect on AIS patients who have not been treated with thrombolytic the

关 键 词：急性缺血性脑卒中 替罗非班 丁苯酞 发病24h内 未行溶取栓 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]