替罗非班序贯治疗不同类型急性进展性脑梗死的临床疗效研究  

Study on clinical efficacy of sequential treatment with tirofiban on different types of acute progressive cerebral infarction

作　　者：崔燕 CUI Yan(Department of Neurology,Caoxian People's Hospital,Heze 274400,China)

机构地区：[1]山东曹县人民医院神经内科,274400

出　　处：《中国现代药物应用》2023年第24期1-5,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨替罗非班序贯治疗不同类型急性进展性脑梗死患者的疗效及安全性。方法 回顾性分析124例急性进展性脑梗死患者的临床资料,根据TOAST分型将患者分为观察组(穿支动脉型,68例)和对照组(大动脉狭窄型, 56例)。所有患者均在双重抗血小板或静脉溶栓治疗后48 h内出现进展,进展后均及时给予替罗非班序贯治疗。比较两组患者入院时、进展时及治疗7、30、90 d的美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin评分量表(mRS)评分,治疗90 d的疗效,出血发生情况。结果 观察组患者入院时、进展时及治疗7、30、90 d的NIHSS评分分别为(13.78±5.05)、(12.31±3.76)、(5.65±2.72)、(4.43±2.24)、(1.85±2.22)分,对照组患者入院时、进展时及治疗7、30、90 d的NIHSS评分分别为(13.23±4.79)、(11.93±3.60)、(9.52±3.03)、(7.89±3.26)、(6.66±3.38)分。两组患者入院时、进展时的NIHSS评分比较差异均无统计学意义(P>0.05);观察组患者治疗7、30、90 d的NIHSS评分均明显低于对照组,差异具有统计学意义(P<0.05)。观察组患者入院时、进展时及治疗7、30、90 d的mRS评分分别为(3.57±0.58)、(3.38±0.52)、(2.78±1.46)、(1.59±1.43)、(1.09±1.46)分,对照组患者入院时、进展时及治疗7、30、90 d的mRS评分分别为(3.52±0.60)、(3.55±0.50)、(3.34±1.79)、(2.93±1.09)、(2.64±1.27)分。两组患者入院时、进展时、治疗7 d的mRS评分比较差异均无统计学意义(P>0.05);观察组治疗30、90 d的mRS评分均低于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗90 d的总有效率72.06%高于对照组的37.50%,差异具有统计学意义(P<0.05)。观察组患者出血发生率为7.35%,对照组患者出血发生率为12.50%,比较差异无统计学意义(P>0.05)。结论 替罗非班序贯治疗急性进展性穿支动脉型脑梗死的疗效确切,能够有效阻止病情进展,改善神经功能,明显优于大动脉狭窄型脑梗死。Objective To discuss the efficacy and safety of sequential treatment with tirofiban on different types of acute progressive cerebral infarction.Methods The clinical data of 124 patients with acute progressive cerebral infarction were retrospectively analyzed.According to TOAST classification,the patients were divided into an observation group(perforator artery type,68 cases)and a control group(stenosis type,56 cases).All patients showed progression within 48 h after dual antiplatelet or intravenous thrombolysis treatment,and sequential treatment with tirofiban was given promptly after progression.Both groups were compared in terms of National Institutes of Health Stroke Scale(NIHSS)score and Modified Rankin Scale(mRS)score at admission,progression,7,30,and 90 d of treatment,and the efficacy after 90 d of treatment and occurrence of hemorrhage.Results NIHSS scores of the observation group were(13.78±5.05),(12.31±3.76),(5.65±2.72),(4.43±2.24)and(1.85±2.22)points at admission,progression and 7,30 and 90 d of treatment;NIHSS scores of the control group were(13.23±4.79),(11.93±3.60),(9.52±3.03),(7.89±3.26)and(6.66±3.38)points at admission,progression and 7,30 and 90 d after treatment.There was no statistically significant difference in NIHSS score at admission and progression between the two groups(P>0.05).NIHSS scores of the observation group were significantly lower than those of the control group at 7,30 and 90 d of treatment,and the differences were statistically significant(P<0.05).mRS scores at admission,progression and 7,30 and 90 d of treatment in the observation group were(3.57±0.58),(3.38±0.52),(2.78±1.46),(1.59±1.43)and(1.09±1.46)points;mRS scores of the control group were (3.52±0.60), (3.55±0.50), (3.34±1.79), (2.93±1.09) and (2.64±1.27) points at admission, progression and 7, 30 and 90 d after treatment. There was no statistically significant difference in mRS scores at admission, progression and 7 d of treatment between the two groups (P>0.05). At 30 and 90 d of treatment, mRS scores

关 键 词：替罗非班 穿支动脉型脑梗死 大动脉狭窄型脑梗死 急性进展性 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]