盐酸替罗非班注射液治疗超静脉溶栓时间窗急性脑梗死疗效观察  

Efficacy of Tirofiban Hydrochloride Injection in the Treatment of Acute Cerebral Infarction Beyond the Intravenous Thrombolysis Time Window:An Observational Study

作　　者：周显林 ZHOU Xianlin(Renhuai People's Hospital,Renhuai 564500,China)

机构地区：[1]仁怀市人民医院,贵州仁怀564500

出　　处：《中华灾害救援医学》2024年第7期833-835,863,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探索超静脉溶栓窗的急性脑梗死患者采取替罗非班治疗的效果。方法选取2021年6月至2023年6月仁怀市人民医院收治的102例超静脉溶栓时间窗的急性脑梗死患者。分为观察组(盐酸替罗非班氯化钠注射液静脉泵入)和对照组(口服阿司匹林肠溶片+硫酸氯吡格雷片)。比较两组的临床疗效、神经功能、氧化应激、炎症水平、不良反应。结果试验组的治疗有效率(92.16%)比对照组(0.59%)高,差异有统计学意义(P=0.005)。治疗7d及2周后,两组神经功能均改善,试验组NIHSS评分均低于对照组(P值均<0.001)。治疗后,两组丙二醛(Malondialdehyde,Mad)水平降低,谷胱甘肽过氧化物酶(Glutathione peroxidase,GPx)和超氧化物歧化酶(Superoxide Dismutase,SOD)水平升高;试验组Mad低于对照组(P<0.001),GPx和SOD高于对照组(P值均<0.001);两组超敏C反应蛋白(High Sensitive C Reaction Protein,hs-CPR)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(TumorNecrosisFactor,TNF-α)均降低,试验组以上炎症指标均低于对照组(P<0.001)。试验组和对照组不良反应发生率无显著差异(P>0.05)。结论替罗非班可有效改善超静脉溶栓时间窗的急性脑梗死患者的神经功能,降低氧化应激和炎症反应,安全性高,临床疗效显著。Objective To explore the efficacy of tirofiban treatment in patients with acute cerebral infarction beyond the transvenous thrombolysis window.Method 102 patients with acute cerebral infarction beyond the transvenous thrombolysis window admitted to Renhuai People's Hospital from June 2021 to June 2023 were selected.They were divided into the observation group(intravenous infusion of tirofiban hydrochloride and sodium chloride injection)and the control group(oral aspirin enteric coated tablets+clopidogrel bisulfate tablets).We compared the clinical efficacy,neurological function,oxidative stress,inflammation levels,and adverse reactions between the two groups.Results The treatment efficacy rate of the observation group(92.16%)was higher than that of the control group(0.59%),and the difference was statistically significant(P=0.005).After 7 days and 2 weeks of treatment,both groups showed improvement in neurological function,and the NIHSS scores in the observation group were lower than those in the control group(P values<0.001).After treatment,the levels of malondialdehyde(Mad)decreased in both groups,while the levels of glutathione peroxidase(GPx)and superoxide dismutase(SOD)increased;The Mad of the observation group was lower than that of the control group(P<0.001),while the GPx and SOD of the observation group were higher than those of the control group(both P values<0.001);Both groups showed a decrease in high-sensitivity C-reactive protein(hs CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α).The inflammatory indicators in the observation group were lower than those in the control group(P<0.001).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Tirofiban can effectively improve the neurological function,reduce oxidative stress and inflammatory response in patients with acute cerebral infarction beyond the time window of intravenous thrombolysis,with high safety and significant clinical efficacy.

关 键 词：血栓溶解疗法 脑梗死 氧化性应激 

分 类 号：R743[医药卫生—神经病学与精神病学]