rt-PA静脉溶栓后应用替罗非班对急性前循环大血管闭塞性脑卒中患者Hcy、FIB、ESR水平的影响  

Effect of using tirofiban after intravenous thrombolysis with rt-PA on the levels of Hcy,FIB and ESR in patients with anterior circulation-large vessel occlusion

作　　者：王瑶 张雪娟[1] WANG Yao;ZHANG Xuejuan(Department of Neurology,Tianjin Baodi Hospital,Tianjin 301800,China)

机构地区：[1]天津市宝坻区人民医院神经内科,天津301800

出　　处：《中国处方药》2024年第11期123-126,共4页Journal of China Prescription Drug

摘　　要：目的 探讨重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后应用替罗非班对急性前循环大血管闭塞性脑卒中(AC-LVO)患者同型半胱氨酸(Hcy)、纤维蛋白原(FIB)、红细胞沉降率(ESR)水平的影响。方法 选取2022年1月~2024年1月收治的60例ACLVO患者,采用抽签法随机分为两组各30例。对照组给予阿替普酶静脉溶栓,研究组在阿替普酶溶栓后给予替罗非班静脉泵入。比较两组Hcy、FIB、ESR、血小板抑制率、美国国立卫生研究院卒中量表(NIHSS)评分、溶栓后血管再闭塞、症状性颅内出血(sICH)发生率及预后。结果 与治疗前相比,研究组治疗3 d和7 d后Hcy、FIB和ESR水平均下降(P <0.05),对照组治疗7 d后Hcy、FIB和ESR水平下降(P <0.05);两组治疗3 d和7 d后NIHSS评分均下降(P <0.05),血小板抑制率均升高(P <0.05)。与对照组相比,研究组治疗3 d和7 d后Hcy、FIB和ESR较低,血小板抑制率较高,NIHSS评分较低(P <0.05)。两组溶栓后血管再闭塞(6.67%vs. 16.67%)、sICH发生率(3.33%vs. 10.00%)比较,差异无统计学意义(P> 0.05)。与对照组相比,研究组预后良好率较高(76.67%vs. 50.00%,P <0.05)。结论rt-PA静脉溶栓后应用替罗非班可降低AC-LVO患者的Hcy、FIB、ESR水平,提高血小板抑制率,促进神经功能恢复,改善预后。Objective To investigate the effect of using tirofiban after intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)on the levels of homocysteine(Hcy),fibrinogen(FIB)and erythrocyte sedimentation rate(ESR)in patients with anterior circulation large vessel occlusion(AC-LVO).Methods A total of 60 patients with AC-LVO admitted from January 2022 to January 2024 were selected and randomly divided into two groups by lottery,with 30 cases in each group.The control group underwent intravenous thrombolysis with alteplase,while the study group underwent intravenous infusion of tirofiban after thrombolysis with alteplase.The two groups were compared on Hcy,FIB,ESR,platelet inhibition rate,National Institutes of Health Stroke Scale(NIHSS)score,incidence rates of vascular reocclusion after thrombolysis and symptomatic intracranial hemorrhage(sICH),and the prognosis.Results Compared to before treatment,the levels of Hcy,FIB and ESR were decreased in the study group after 3 days and 7 days of treatment(P<0.05),and the levels of Hcy,FIB and ESR were decreased in the control group after 7 days of treatment(P<0.05).After 3 days and 7 days of treatment,the NIHSS scores were decreased in both groups(P<0.05),and the platelet inhibition rates were increased(P<0.05).Compared with the control group,the study group had lower Hcy,FIB and ESR levels,higher platelet inhibition rate,and lower NIHSS score after 3 days and 7 days of treatment(P<0.05).There was no statistically significant difference between the two groups in the incidence rates of vascular reocclusion(6.67%vs.16.67%)and sICH(3.33%vs.10.00%)after thrombolysis(P>0.05).Compared with the control group,the good prognosis rate was higher in the study group(76.67%vs.50.00%,P<0.05).Conclusion Using tirofiban after intravenous thrombolysis with rt-PA can decrease the levels of Hcy,FIB and ESR,increase platelet inhibition rate,promote neurological function recovery,and improve the prognosis in patients with AC-LVO.

关 键 词：前循环大血管闭塞性脑卒中 替罗非班 同型半胱氨酸 纤维蛋白原 红细胞沉降率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]