替罗非班联合巴曲酶治疗急性进展性脑梗死的疗效及对CKLF1、YKL-40和神经功能的影响  

Efficacy of Tirofiban Combined with Batroxase in Treatment of Acute Progressive Cerebral Infarction and Its Effect on CKLF1,YKL-40 and Neurological Function

作　　者：曹成婷 杨言府[1] 方无杰 黄友发 洪亮[1] CAO Chengting;YANG Yanfu;FANG Wujie;HUANG Youfa;HONG Liang(Department of Neurology,Lu′an Hospital of Traditional Chinese Medicine/Lu′an Hospital Affiliated to Anhui University of Chinese Medicine,Lu′an 237000,China)

机构地区：[1]六安市中医院安徽中医药大学附属六安医院神经内科,安徽六安237000

出　　处：《医学综述》2022年第18期3701-3705,共5页Medical Recapitulate

基　　金：安徽省重点研究和开发计划项目(1804h08020297)。

摘　　要：目的探讨替罗非班联合巴曲酶治疗急性进展性脑梗死的疗效及对趋化素样因子1(CKLF1)、甲壳质酶蛋白40(YKL-40)和神经功能的影响。方法选择2019年1月至2021年1月六安市中医院收治的101例急性进展性脑梗死患者为研究对象,根据治疗方案不同分为两组:对照组(50例)采用巴曲酶治疗,10 BU加入100 ml 0.9%氯化钠溶液中静脉滴注;试验组(51例)在对照组的基础上联合替罗非班治疗,12.5 mg加入5%葡萄糖注射液中静脉滴注,两组均治疗2周。比较两组的临床疗效,治疗前后CKLF1、YKL-40、美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)、血管内皮生长因子(VEGF)、同型半胱氨酸(Hcy)及神经元特异性烯醇化酶(NSE)水平变化,以及不良反应发生情况。结果CKLF1、YKL-40治疗前后和组间的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01);治疗后,试验组CKLF1、YKL-40水平均低于对照组(P<0.05)。NIHSS和BI评分治疗前后和组间的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01);治疗后,试验组NIHSS评分低于对照组,BI评分高于对照组(P<0.05)。治疗后,试验组总有效率高于对照组[80.39%(41/51)比60.00%(30/50)](χ^(2)=5.028,P=0.025)。VEGF、Hcy及NSE治疗前后和组间的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01);治疗后,试验组VEGF、Hcy及NSE水平均低于对照组(P<0.05)。试验组不良反应发生率为7.84%(4/51),对照组为18.00%(9/50),两组比较差异无统计学意义(χ^(2)=2.323,P=0.128)。结论替罗非班联合巴曲酶治疗急性进展性脑梗死中的疗效显著,可有效改善患者CKLF1、YKL-40及神经功能。Objective To study the efficacy of tirofiban combined with batroxase in the treatment of acute progressive cerebral infarction and its effect on chemokine like factor 1(CKLF1),chitinase protein 40(YKL-40)and neurological function.Methods A total of 101 patients with acute progressive cerebral infarction admitted to Lu′an Hospital of Traditional Chinese Medicine from Jan.2019 to Jan.2021 were included,and were divided into a control group(50 cases)and a test group(51 cases)according to different treatment regimens.The control group was treated with batroxidase,adding 100 ml 0.9%sodium chloride solution into 10 BU by intravenous infusion.The test group was additionally treated with tirofiban,12.5 mg added into 5%glucose injection by intravenous infusion,and both groups were treated for 2 weeks.The clinical efficacy,changes of CKLF1,YKL-40,National Institute of Health stroke scale(NIHSS),Barthel index(BI),vascular endothelial growth factor(VEGF),homocysteine(Hcy)and neuron specific enolase(NSE)levels before and after treatment,and incidence of adverse reactions were compared between the two groups.Results There were statistically significant differences in the main effects of CKLF1 and YKL-40 before and after treatment(P<0.01),and between the two groups(P<0.01).There were interactions between groups and time points(P<0.01).After treatment,the levels of CKLF1 and YKL-40 in the test group were lower than those in the control group(P<0.05).There were significant differences in NIHSS and BI scores before and after treatment(P<0.01),and between the two groups(P<0.01).There were interactions between groups and time points(P<0.01).After treatment,NIHSS score of the test group was lower than the control group,BI score in the test group was higher than that in the control group(P<0.05).After treatment,the total effective rate of the test group was higher than that of the control group[80.39%(41/51)vs 60.00%(30/50)](χ^(2)=5.028,P=0.025).There were significant differences in the main effects of VEGF,Hcy and NSE before and a

关 键 词：急性进展性脑梗死 替罗非班 巴曲酶 趋化素样因子1 甲壳质酶蛋白40 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]