替罗非班对非大血管闭塞性缺血性卒中患者的疗效及凝血功能的影响  

Effect of Tirofiban on the Efficacy and Coagulation Function of Patients with Non-large Vessel Occlusive Ischemic Stroke

作　　者：祝秀蓉 赵洪 梁世福 吴有林[1] ZHU Xiu-Rong;ZHAO Hong;LIANG Shi-Fu;WU You-Lin(Department of Neurology,Chongzhou People's Hospital,Chengdu 611230,China)

机构地区：[1]崇州市人民医院神经内科,成都611230

出　　处：《中国药物经济学》2025年第3期39-42,46,共5页China Journal of Pharmaceutical Economics

基　　金：四川省医学会医学科研青年创新项目(Q21082)。

摘　　要：目的探讨替罗非班对非大血管闭塞性缺血性卒中患者的疗效及凝血功能的影响。方法选取2022年6月至2023年11月于崇州市人民医院就诊的85例急性非大血管闭塞性缺血性卒中患者为研究对象。根据是否接受替罗非班治疗,将其分为观察组(n=42)和对照组(n=43)。对照组患者予以阿司匹林和(或)氯吡格雷治疗,观察组患者在对照组基础上采用盐酸替罗非班注射液治疗。比较两组治疗前后神经功能[美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(m RS)评分],血常规指标[血小板计数(PLT)、淋巴细胞计数(LYM)、血小板聚集率、平均血小板体积(MPV)和平均血小板体积/淋巴细胞比值(MPVLR)]以及凝血四项指标[凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)和活化部分凝血活酶时间(APTT)]。结果治疗后,两组NIHSS、m RS评分均降低(P<0.05),且观察组均低于对照组(P<0.05);观察组LYM和PLT均高于对照组(P<0.05),血小板聚集率、MPV和MPVLR均低于对照组(P<0.05);观察组PT、TT和APTT均高于对照组(P<0.05),FIB低于对照组(P<0.05)。结论对于超时间窗的急性非大血管闭塞性缺血性卒中患者,发病早期注射替罗非班的疗效优于双重抗血小板疗法。Objective To explore the efficacy of early tirofiban use in patients with acute non-large vessel occlusive ischemic stroke and its impact on coagulation function.Methods A total of 85 patients with acute non-large vascular occlusive ischemic stroke treated in Chongzhou People's Hospital from June 2022 to November 2023 were selected as the study objects.They were divided into observation group(n=42)and control group(n=43),aspirin and/or clopidogrel depending on whether they received tirofiban.The control group was treated with aspirin and/or clopidogrel,and the observation group was treated with Tirofiban hydrochloride injection based on the control group.Neurological function[National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(mRS)scores],Blood routine indicators[platelet count(PLT),lymphocyte count(LYM),platelet aggregation rate,mean platelet volume(MPV)and mean platelet volume/lymphocyte ratio(MPVLR)]and four coagulation indicators[prothrombin time(PT),fibrinogen(FIB),thrombin time(TT)and activated partial thromboplastin Time(APTT)]were compared between the two groups before and after treatment.Results After treatment,the scores of NIHSS and mRS in both groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).LYM and PLT in observation group were higher than those in control group(P<0.05),platelet aggregation rate,MPV and MPVLR were lower than those in control group(P<0.05).PT,TT and APTT in observation group were higher than those in control group(P<0.05),and FIB was lower than those in control group(P<0.05).Conclusion TThe efficacy of tirofiban injection in the early stage is superior to dual antiplatelet therapy in patients with acute non-large vessel occlusive ischemic stroke over the time window.

关 键 词：缺血性脑卒中 替罗非班 非大血管闭塞 脑梗死 凝血功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R971[医药卫生—临床医学]