小剂量替罗非班联合机械取栓治疗急性脑梗死的临床疗效  

Clinical Efficacy of Low-Dose Tirofiban Combined with Mechanical Thrombectomy in the Treatment of Acute Cerebral Infarction

作　　者：冯江伟 王东梅 李浩浩 FENG Jiangwei;WANG Dongmei;LI Haohao(First Neurology Ward,Luoning County People's Hospital,Luoyang Henan 471700)

机构地区：[1]河南省洛宁县人民医院神经内科一病区,河南洛阳471700

出　　处：《医学临床研究》2024年第9期1402-1405,共4页Journal of Clinical Research

摘　　要：【目的】探讨小剂量替罗非班联合机械取栓治疗急性脑梗死(ACI)的临床疗效。【方法】选择81例行机械取栓的ACI患者,采用随机数字表法将其分为对照组(n=40)和观察组(n=41)。对照组术后给予负荷剂量300 mg的阿司匹林+75 mg氯吡格雷治疗,观察组在此基础上给予替罗非班治疗。采用脑梗死溶栓评分(mTICI)评估两组患者术后24 h的血管再通率;比较两组患者术前、术后3 d血清一氧化氮(NO)与内皮素-1(ET-1)的水平,血小板聚集率,神经功能及恢复情况;比较两组不良反应发生情况。【结果】两组患者术后24 h的血管再通率比较,差异无统计学意义(P>0.05);术后3 d,观察组患者血清NO、ET-1与血小板聚集率低于对照组(均P<0.05);观察组患者美国国立卫生研究院卒中量表(NIHSS)评分和Rankin评分均低于对照组(均P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】小剂量替罗非班联合机械取栓治疗ACI可以有效改善患者血管再通情况及血管内皮功能,减轻脑组织损伤,改善神经功能,且安全性较好。【Objective】To investigate the clinical efficacy of low-dose Tirofiban combined with mechanical thrombectomy in the treatment of acute cerebral infarction(ACI).【Methods】A total of 81 ACI patients who underwent vascular thrombectomy were randomly divided into a control group(40 cases)and an observation group(41 cases).The control group underwent mechanical thrombectomy and was treated postoperatively with a loading dose of 300 mg aspirin+75 mg clopidogrel.The observation group received Tirofiban treatment in addition to the control group's regimen.The modified Thrombolysis in Cerebral Infarction(mTICI)score was used to compare the vascular recanalization rates of the two groups 24 hours after surgery.Serum levels of nitric oxide(NO)and endothelin-1(ET-1),platelet aggregation rate,neurological function,and recovery were compared between the two groups before and 3 days after surgery.The incidence of adverse reactions was also compared.【Results】There was no statistically significant difference in the vascular recanalization rate between the two groups 24 hours after surgery(P>0.05).Three days post-surgery,the observation group had lower serum NO and ET-1 levels and lower platelet aggregation rate compared to the control group(all P<0.05).The observation group also had lower National Institutes of Health Stroke Scale(NIHSS)scores and Rankin scores compared to the control group(both P<0.05).There was no statistically significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Low-dose Tirofiban combined with mechanical thrombectomy for ACI can effectively improve blood flow and vascular endothelial function,alleviate brain tissue damage,and improve neurological function with good safety.

关 键 词：脑梗死/外科学 脑梗死/药物疗法 急性病 替罗非班/药理学 血栓溶解疗法 

分 类 号：R743.33[医药卫生—神经病学与精神病学]