溶栓联合替罗非班对缺血性脑血管疾病患者神经功能及预后的影响  

Effect of thrombolysis combined with tirofiban on neurological function and prognosis in patients with ischemic cerebrovascular disease

作　　者：董明安 赵礼荣 王琪 DONG Ming-an;ZHAO Li-rong;WANG Qi(Department of Neurology,the Second People's Hospital of Pingdingshan City,Pingdingshan,Henan 467000,China)

机构地区：[1]平顶山市第二人民医院神经内二科,河南平顶山467000

出　　处：《医药论坛杂志》2025年第3期323-327,共5页Journal of Medical Forum

摘　　要：目的探讨溶栓联合替罗非班应用于缺血性脑血管疾病(ischemi ccerebrovascul ariseas,ICVD)患者的治疗中,对神经功能及预后的影响。方法2021年10月—2023年5月期间,选取96例ICVD患者,分组方法为随机数表法,分为对照组(48例,溶栓治疗)和研究组(48例,溶栓联合替罗非班治疗),比较两组神经功能,凝血-溶纤指标,双侧大脑中动脉、基底动脉的血流,预后情况。结果与治疗前比较,两组治疗后1 d、14 d的美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分降低,差异有统计学意义(P<0.05),且与对照组比较,研究组治疗后1 d、14 d的NIHSS评分更低,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后14 d的D二聚体(D-dimer,D-D)升高,差异有统计学意义(P<0.05),两组治疗后14 d的纤维蛋白原(fibrinogen,FIB)、血小板聚集(platelet aggregation,PAg)率、血小板黏附(platelet adhesion,PAd)率降低,差异有统计学意义(P<0.05),与对照组比较,研究组治疗后14 d的D-D、FIB、PAg率、PAd率更低,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后14 d的左右侧大脑中动脉、基底动脉的血流升高,差异有统计学意义(P<0.05),与对照组比较,研究组治疗后14 d的左右侧大脑中动脉、基底动脉的血流更低(P<0.05)。与对照组比较,研究组的症状性内出血率、颅内出血率差异无统计学意义(P>0.05),研究组预后不良率、死亡率更低,差异有统计学意义(P<0.05)。结论溶栓联合替罗非班治疗ICVD患者,可改善神经功能,降低凝血-溶纤指标,提高双侧大脑中动脉、基底动脉的血流,降低预后不良率和死亡率。Objective To explore the effects of thrombolysis combined with tirofiban on neurological function and prognosis in patients with ischemic cerebrovascular disease(ICVD)Methods From October 2021 to May 2023,96 patients with ICVD were selected and divided into a control group(48 cases,thrombolysis treatment)and a study group(48 cases,thrombolysis combined with tirofiban treatment)using a random number table method.The neurological function,coagulation fibrinolysis indicators,bilateral middle cerebral artery and basilar artery blood flow,and prognosis of the two groups were compared.Results Compared with before treatment,the National Institutes of Health Stroke Scale(NIHSS)scores of the two groups decreased on the 1st and 14th day after treatment(P<0.05),and compared with the control group,the study group had lower NIHSS scores on the 1st and 14th day after treatment(P<0.05).Compared with before treatment,the D-dimer(D-D)levels in both groups increased 14 days after treatment(P<0.05),while fibrinogen(FIB),platelet aggregation(PAg)rate,and platelet adhesion(PAd)rate decreased 14 days after treatment(P<0.05).Compared with the control group,the D-D,FIB,PAg rate,and PAd rate in the study group were lower 14 days after treatment(P<0.05).Compared with before treatment,the blood flow of the left and right middle cerebral arteries and basilar arteries in both groups increased 14 days after treatment(P<0.05).Compared with the control group,the blood flow of the left and right middle cerebral arteries and basilar arteries in the study group was lower 14 days after treatment(P<0.05).Compared with the control group,the symptomatic internal bleeding rate and intracranial hemorrhage rate of the study group were not statistically significant(P>0.05),while the poor prognosis rate and mortality rate of the study group were lower(P<0.05).Conclusion The combination of thrombolysis and tirofiban in the treatment of ICVD patients can improve neurological function,reduce coagulation fibrinolysis indicators,increase blood flow in bilateral

关 键 词：缺血性脑血管疾病 溶栓 替罗非班 神经功能 预后 

分 类 号：R543[医药卫生—心血管疾病]