摘要
目的基于倾向评分匹配分析替罗非班序贯双重抗血小板治疗(DAPT)对穿支动脉粥样硬化病(BAD)患者预后的影响及其安全性。方法选取2021年10月—2023年6月新乡医学院第一附属医院神经内科收治的BAD患者128例,根据治疗方案将患者分为DAPT组和联合组,DAPT组患者接受阿司匹林肠溶片或吲哚布芬片联合硫酸氢氯吡格雷片治疗,联合组患者接受盐酸替罗非班氯化钠注射液静脉滴注48 h,停用前4 h序贯DAPT。发病后90 d,记录患者主要预后指标[包括早期神经功能恶化(END)发生率、功能预后良好率]、次要预后指标[包括住院期间美国国立卫生研究院卒中量表(NIHSS)评分变化幅度、卒中复发率]、安全性指标(严重出血事件发生率)、死亡情况。结果匹配前DAPT组90例,联合组38例。匹配后DAPT组31例,联合组31例。联合组END发生率低于DAPT组,功能预后良好率高于DAPT组(P<0.05);两组住院期间NIHSS评分变化幅度、卒中复发率、严重出血事件发生率比较,差异无统计学意义(P>0.05)。两组均无死亡患者。结论替罗非班序贯DAPT可减少BAD患者END的发生,提高其功能预后良好率,且不增加严重出血事件及死亡的风险。
Objective To investigate the effect of tirofiban sequential dual antiplatelet therapy(DAPT)on the prognosis of patients with branch atheromatous disease(BAD)and its safety based on propensity score matching.Methods A total of 128 patients with BAD admitted to the Department of Neurology in the First Affiliated Hospital of Xinxiang Medical University from October 2021 to June 2023 were selected.Patients were divided into DAPT group and combination group according to treatment plans.Patients in the DAPT group received aspirin enteric coated tablets or indobufen tablets combined with clopidogrel bisulfate tablets,while patients in the combination group received intravenous infusion of tirofiban hydrochloride and sodium chloride injection for 48 hours,and DAPT was sequentially administered at 4 hours before discontinuation.Ninety days after onset of illness,main prognostic indicators[including the incidence of early neurological deterioration(END)and the rate of good functional prognosis],secondary prognostic indicators[including changes of National Institute of Health Stroke Scale(NIHSS)scores during hospitalization and stroke recurrence rate],and safety indicators(incidence of severe bleeding events)and death were recorded.Results Before matching,there were 90 cases in DAPT group and 38 cases in combination group.After matching,there were 31 cases in DAPT group and 31 cases in combination group.The incidence of END in combined group was lower than that in DAPT group,and the rate of good functional prognosis was higher than that in DAPT group(P<0.05).There was no statistically significant difference in changes of NIHSS scores during hospitalization,stroke recurrence rate,and incidence of severe bleeding events between the two groups(P>0.05).There were no deaths in the both two groups.Conclusion Tirofiban sequential DAPT can reduce the occurrence of END in patients with BAD,improve the rate of good functional prognosis,and does not increase the risk of severe bleeding events and death.
作者
于美艳
李冰杰
常敏
李旭
张平
闫海清
YU Meiyan;LI Bingjie;CHANG Min;LI Xu;ZHANG Ping;YAN Haiqing(Department of Neurology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)
出处
《实用心脑肺血管病杂志》
2024年第9期120-124,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200488)
河南省神经修复重点实验室开放课题资助项目(HNSJXF-2021-004)。
作者简介
通信作者:闫海清,E-mail:yhqsjnk@163.com。
