摘要
目的探讨替罗非班治疗进展性脑梗死疗效及安全性,尤其对进展性脑梗死的效果最佳。方法统计郑州大学附属郑州中心医院2017-01—2018-12所有接受静脉溶栓的进展性缺血性脑梗死患者,根据患者是否应用替罗非班分为2组,观察组为接受替罗非班治疗,并根据患者的责任血管分型(大动脉粥样硬化型或小动脉闭塞型),对照组为未接受替罗非班治疗。根据美国国立卫生研究院卒中量表(NIHSS)评分及改良Rankin评分(modified Rankin Scale,mRS),观察应用替罗非班前后各个时间点的进展性脑梗死患者NIHSS评分及3个月后mRS评分,评估静脉溶栓后病情仍进展的脑梗死患者应用替罗非班的疗效、安全性及替罗非班对进展性缺血性脑卒中的疗效最佳。结果观察组1 h、2 h、12 h、24 h及7 d的NIHSS评分均低于对照组,2组间差异有统计学意义(P<0.05);观察组3个月的mRS评分低于对照组,2组间差异有统计学意义(P<0.05);观察组中小动脉闭塞型1 h、2 h、12 h、24 h及7 d的NIHSS评分低于大动脉粥样硬化型,差异有统计学意义(P<0.05)。3个月的mRS评分低于大动脉粥样硬化型,差异有统计学意义(P<0.05)。结论替罗非班可改善进展性脑梗死患者神经功能缺损症状,且出血风险低,尤其对小动脉闭塞型进展性脑梗死患者效果最佳。
Objective To investigate the efficacy and safety of tirofiban in the treatment of progressive cerebral infarction,especially for which type of progressive cerebral infarction treated best.Methods Statistics our department from January 2017 to December 2018 all patients with progressive ischemic cerebral infarction undergoing intravenous thrombolysis,according to whether patients were treated with tirofiban,they were divided into two groups,the observation group was treated with tirofiban,and according to the responsibility of the patient blood vessel classification(atherosclerotic type of aorta or arteriolar occlusion),the control group did not receive tirofiban.According to the National Institutes of Health Stroke Scale(NIHSS)score and modified Rankin Scale(modified Rankin Scale,mRS),observing the NIHSS score of patients with progr-essive cerebral infarction at various time points before and after tirofiban and the mRS after 3 months,to evaluate the efficacy and safety of tirofiban in patients with cerebral infarction who were still progressing after intravenous thrombolysis,and to determine which type of progressive ischemic stroke was the best for tirofiban.Results The NIHSS scores of the observation group were lower than the control group at 1 hour,2 hours,12 hours,24 hours and 7 days,the difference between the two groups was statistically significant(P<0.05).The mRS score of the observation group was lower than that of the control group at three months,and the difference between the two groups was statistically significant(P<0.05).The NIHSS scores of the small arterial occlusion type in the observation group were lower than the aortic atherosclerosis type at 1 hour,2 hours,12 hours,24 hours and 7 days,the difference was statistically significant(P<0.05).The mRS scores of three months was lower than that of aortic atherosclerosis,and the difference was statistically significant(P<0.05).Conclusion Tirofiban can improve the symptoms of neurological deficit in patients with progressive cerebral infarction,and the risk of bleeding is low,especially for patients with small artery occlusion type progressive cerebral infarction.
作者
马冬璞
肖茜茜
李菲菲
朱小倩
梁冬忆
牛金朵
赵志玲
MA Dongpu;XIAO Xixi;LI Feifei;ZHU Xiaoqian;LIANG Dongyi;NIU Jinduo;ZHAO Zhiling(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《中国实用神经疾病杂志》
2020年第7期576-580,共5页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关计划项目(编号:2018020769)。
作者简介
马冬璞,Email:15290878649@163.com。
