巴曲酶序贯替罗非班治疗超溶栓时间窗急性脑梗死的临床效果  

Clinical effect of Batroxobin sequential Tirofiban in the treatment of acute cerebral infarction beyond the thrombolysis time window

作　　者：陈文鑫[1] 李鑫[1] 梁小清 吴学良[1] 方金萍 陈镇楷 CHEN Wenxin;LI Xin;LIANG Xiaoqing;WU Xueliang;FANG Jinping;CHEN Zhenkai(Department of Neurology,Puning People's Hospital,Guangdong Province,Puning515300,China;Department of Pharmacy,Puning People's Hospital,Guangdong Province,Puning515300,China)

机构地区：[1]广东省普宁市人民医院神经内科,广东普宁515300 [2]广东省普宁市人民医院药剂科,广东普宁515300

出　　处：《中国当代医药》2023年第10期113-117,共5页China Modern Medicine

基　　金：广东省揭阳市科技计划项目(201012094841081)。

摘　　要：目的探讨巴曲酶序贯替罗非班治疗超静脉溶栓时间窗急性脑梗死的临床效果和安全性。方法选取2020年1月至2022年2月普宁市人民医院神经内科收治的120例超溶栓时间窗急性脑梗死患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组60例。对照组予以常规药物治疗,治疗组予以巴曲酶序贯替罗非班治疗24 h,在替罗非班治疗结束前4 h口服阿司匹林肠溶片抗血小板聚集治疗。比较两组治疗前及治疗1、7、14 d的美国国立卫生研究院卒中量表(NIHSS)评分,记录两组治疗前、出院后3个月改良Rankin量表(mRS)≤2分的例数以及治疗前、治疗后48 h的纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、血小板计数(PLT)水平和临床不良反应发生情况。结果两组治疗1 d的NIHSS评分均低于本组治疗前,差异有统计学意义(P<0.01)。两组治疗7 d的NIHSS评分均低于本组治疗1 d,差异有统计学意义(P<0.01)。两组治疗14 d的NIHSS评分均低于本组治疗7 d,差异有统计学意义(P<0.01)。治疗组治疗7、14 d的NIHSS评分低于对照组,差异有统计学意义(P<0.05)。在时间和组别交互效应影响下,两组的NIHSS评分差异有统计学意义(F=39.856,P<0.01)。随着治疗时间的延长,治疗组的NIHSS评分下降幅度较对照组更大。治疗前两组mRS≤2分的例数比较,差异无统计学意义(P>0.05)。出院3个月,两组mRS≤2分的例数均多于本组治疗前,差异均有统计学意义(P<0.01)。出院3个月,治疗组mRS≤2分的例数多于对照组,差异有统计学意义(P<0.05)。治疗组治疗后48 h的FIB水平低于本组治疗前,差异有统计学意义(P<0.01)。对照组治疗前和治疗后48 h的FIB水平比较,差异无统计学意义(P>0.05)。两组治疗前和治疗后48 h的PT、APTT、PLT水平比较,差异无统计学意义(P>0.05)。两组的临床不良反应发生情况比较,差异无统计学意义(P>0.05)。结论巴�Objective To investigate the clinical effect and safety of Batroxobin sequential Tirofiban in patients with acute cerebral infarction beyond the thrombolysis time window.Methods From January 2020 to February 2022,120 patients with acute cerebral infarction beyond the thrombolysis time window in the Department of Neurology of Puning People's Hospital were selected as the research objects.They were divided into the treatment group and the control group according to the random number table method,with 60 cases in the each group.The control group was treated with conventional medical therapy.The treatment group was treated with Batroxobin sequential Tirofiban for 24 hours,Aspirin Enteric-Coated tablets were taken orally for antiplatelet aggregation at 4 hours before the end of Tirofiban treatment.The scores of the National Institutes of Health stroke scale(NIHSS)before treatment and on the 1st,7th and 14th day of treatment were compared between the two groups,and the number of patients with modified Rankin scale(mRS)≤2 points before treatment and at 3 months after discharge,as well as the levels of fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT),platelet count(PLT)and clinical adverse reactions before treatment and at 48 hours after treatment were recorded.Results The NIHSS scores on the first day of treatment in the two groups were lower than those before treatment,the differences were statistically significant(P<0.01).The NIHSS score of the two groups after 7 days of treatment was lower than that after 1 day of treatment,the difference was statistically significant(P<0.01).The NIHSS score of the two groups after 14 days of treatment was lower than that after 7 days of treatment,the difference was statistically significant(P<0.01).The NIHSS score of the treatment group on the 7th and 14th day of treatment were lower than those of the control group,the differences were statistically significant(P<0.05).Under the influence of time and group interaction,the difference of NIHSS scores

关 键 词：巴曲酶 替罗非班 急性脑梗死 超溶栓时间窗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]