替罗非班联合颈动脉狭窄支架置入术治疗急性分水岭脑梗死患者的效果及对血浆致动脉硬化指数、脑血管储备功能的影响  

Effect of tirofiban combined with stent implantation for carotid artery stenosis in the treatment of patients with acute watershed cerebral infarction and its influence on atherogenic index of plasma and cerebrovascular reserve capacity

作　　者：赵传清 李国珍[1] 李俊峰 郭新伟 ZHAO Chuanqing;LI Guozhen;LI Junfeng;GUO Xinwei(Department of Neurology,Baoding Second Central Hospital,Baoding 072750,Hebei,China;Department of Neurology,Xingtai Peoples'Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]保定市第二中心医院神经内科,河北省保定市072750 [2]邢台市人民医院神经内科,河北省邢台市054000

出　　处：《广西医学》2023年第4期391-395,413,共6页Guangxi Medical Journal

基　　金：河北省保定市科技计划项目(214IZF025)。

摘　　要：目的探讨替罗非班联合颈动脉狭窄支架置入术治疗急性分水岭脑梗死(ACWI)患者的效果,以及对患者血浆致动脉硬化指数(AIP)、脑血管储备功能(CVR)的影响。方法选取102例ACWI患者作为研究对象,将其随机分为联合组和常规组,各51例。两组均行颈动脉狭窄支架置入术治疗,联合组术后加用替罗非班治疗。比较两组治疗14 d后的临床疗效,以及治疗前和治疗14 d后的美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体]、脑血流灌注(脑血流量、脑血容量)、AIP和CVR。记录两组患者治疗后14 d内出血事件发生情况。结果治疗14 d后,联合组总有效率为94.12%,高于常规组的80.39%(P<0.05);两组的NIHSS评分、FIB水平、D-二聚体水平、AIP均较治疗前降低,而MoCA评分、PT、APTT、脑血流量、脑血容量、CVR均较治疗前升高,且联合组的上述指标均优于常规组(均P<0.05)。两组的出血事件发生率差异无统计学意义(P>0.05)。结论在颈动脉狭窄支架置入术后给予替罗非班辅助治疗可更好地改善ACWI患者的凝血功能及AIP,增加脑血流灌注,提高脑血管储备功能,从而促进神经功能及认知功能的恢复,且不增加出血风险,安全性较高。Objective To explore the effect of tirofiban combined with stent implantation for carotid artery stenosis in the treatment of patients with acute watershed cerebral infarction(ACWI)and its influence on atherogenic index of plasma(AIP)and cerebrovascular reserve capacity(CVR).Methods A total of 102 patients with ACWI were selected as the research subjects,and they were randomly divided into combined group or routine group,with 51 cases in each group.Both groups underwent stent implantation for carotid artery stenosis for treatment,and the combined group was additionally administrated tirofiban for treatment after operation.The clinical efficacy after 14 days of treatment,and the pre-and 14-day post-treatment National Institutes of Health Stroke Scale(NIHSS)score,Montreal Cognitive Assessment(MoCA)score,coagulation function(activated partial thromboplastin time[APTT],prothrombin time[PT],fibrinogen[FIB],and D-dimer),cerebral blood perfusion(cerebral blood flow,cerebral blood volume),AIP,and CVR were compared between the two groups.The occurrence of bleeding events within 14 days after operation in patients of the two groups was recorded.Results After 14 days of treatment,the combined group exhibited a higher total effective rate as compared with the routine group(94.12%vs.80.39%,P<0.05);in addition,the NIHSS score,FIB level,D-dimer level,and AIP were decreased in both groups as compared with before treatment,whereas MoCA score,PT,APTT,cerebral blood flow,cerebral blood volume,and CVR were elevated as compared with before treatment,and the combined group yielded superior aforementioned indices to compared with the routine group(all P<0.05).There was no statistically significant difference in the incidence rate of bleeding events between the two groups(P>0.05).Conclusion Tirofiban adjuvant therapy after stent implantation for carotid artery stenosis can preferably ameliorate coagulation function and AIP,increase cerebral blood perfusion,improve cerebrovascular reserve capacity of ACWI patients,so as to promote the re

关 键 词：急性分水岭脑梗死 替罗非班 颈动脉狭窄支架置入术 治疗效果 血浆致动脉硬化指数 脑血管储备功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]