急性脑梗死介入血管内治疗后替罗非班维持抗血小板的治疗
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摘要
目的探讨急性脑梗死介入血管内治疗后替罗非班维持抗血小板的临床疗效。方法选取2016年1月‐2017年12月该院收治的60例急性脑梗死患者,采用随机数字表法分为观察组(n=30)和对照组(n=30)。两组患者均接受常规介入血管内治疗,对照组介入治疗后给予阿司匹林治疗,观察组介入治疗后给予替罗非班治疗。比较两组患者的治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分和血液流变学指标的变化,并评估其临床疗效和观察出血并发症的发生。结果观察组患者治疗后各时间点的NIHSS评分均低于对照组,治疗14 d后BI评分高于对照组,高切全血粘度、低切全血粘度和血小板聚集率水平均低于对照组(P <0.05);观察组患者的临床治疗有效率高于对照组,出血并发症发生率低于对照组(P <0.05)。结论急性脑梗死介入血管内治疗后使用替罗非班不仅可以改善患者预后,提高治疗效果,又可降低出血并发症的发生。
【Objective】To investigate the clinical efficacy of tirofiban in the prevention of antiplatelet after interventional endovascular treatment for acute cerebral infarction.【Methods】Sixty patients with acute cerebral infarction admitted to our hospital from January 2016 to December 2017 were randomly divided into observation group(n =30) and control group(n =30). Both groups received routine interventional endovascular treatment. The control group received aspirin after interventional therapy. The observation group received tirofiban after interventional therapy. The changes of National Institute of Health Stroke Scale(NIHSS) score, Barthel index(BI) score, hemorheological parameters before and after treatment were compared between the two groups, and the clinical efficacy and bleeding complications were evaluated.【Results】The NIHSS scores of the patients in the observation group were lower than those of the control group at each time point after treatment. The BI score of the observation group was higher than that of the control group 14 days after treatment. The high cut whole blood viscosity, low cut whole blood viscosity and platelet aggregation rate were lower in the observation group than in the control group(P <0.05); the clinical treatment efficiency of the observation group was higher than that of the control group, and the incidence of bleeding complications was lower than that of the control group(P <0.05).【Conclusion】The use of tirofiban after endovascular treatment for acute cerebral infarction can not only improve the prognosis of patients, improve the therapeutic effect, but also reduce the occurrence of bleeding complications.
【Objective】To investigate the clinical efficacy of tirofiban in the prevention of antiplatelet after interventional endovascular treatment for acute cerebral infarction.【Methods】Sixty patients with acute cerebral infarction admitted to our hospital from January 2016 to December 2017 were randomly divided into observation group(n =30) and control group(n =30). Both groups received routine interventional endovascular treatment. The control group received aspirin after interventional therapy. The observation group received tirofiban after interventional therapy. The changes of National Institute of Health Stroke Scale(NIHSS) score, Barthel index(BI) score, hemorheological parameters before and after treatment were compared between the two groups, and the clinical efficacy and bleeding complications were evaluated.【Results】The NIHSS scores of the patients in the observation group were lower than those of the control group at each time point after treatment. The BI score of the observation group was higher than that of the control group 14 days after treatment. The high cut whole blood viscosity, low cut whole blood viscosity and platelet aggregation rate were lower in the observation group than in the control group(P <0.05); the clinical treatment efficiency of the observation group was higher than that of the control group, and the incidence of bleeding complications was lower than that of the control group(P <0.05).【Conclusion】The use of tirofiban after endovascular treatment for acute cerebral infarction can not only improve the prognosis of patients, improve the therapeutic effect, but also reduce the occurrence of bleeding complications.
引文
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[10]Park MR,Min MK,Ryu JH,et al.Multiple cerebral infarct with cerebral vasculitis in a young patient with ulcerative colitis[J].American Journal of Emergency Medicine,2018,36(4):733.e3-733.e5.
[2]田方起.介入溶栓治疗脑梗死临床疗效研究[J].中国全科医学,2017,20(z2):166-167.
[3]蒋锋,王莉,袁婕,等.替罗非班在急性脑梗死支架取栓术中的临床应用[J].现代医学,2017,45(09):1247-1252.
[4]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[5]林露,张猛.血小板糖蛋白IIb/IIIa受体拮抗剂治疗急性缺血性卒中的研究进展[J].中国卒中杂志,2016,11(8):697-703.
[6]郝静,赵娜,孔孟丹,等.替罗非班治疗进展性缺血性卒中的疗效和安全性观察[J].解放军医学院学报,2017,38(5):409-413.
[7]Kontos MC,Lanfear DE,Gosch K,et al.Prognostic value of serial N-terminal pro-brain natriuretic peptide testing in patients with acute myocardial infarction[J].American Journal of Cardiology,2017,120(2):181-185.
[8]黄志宝,何忠莲,汤红薇,等.替罗非班联合丁苯酞注射液治疗进展性脑梗死[J].血栓与止血学,2018,24(01):10-12.
[9]张源萍,宋明宝,晋军,等.经皮冠脉介入法围术期替格瑞洛联合替罗非班抗血小板出血风险临床观察[J].川北医学院学报,2015,30(2):140-143.
[10]Park MR,Min MK,Ryu JH,et al.Multiple cerebral infarct with cerebral vasculitis in a young patient with ulcerative colitis[J].American Journal of Emergency Medicine,2018,36(4):733.e3-733.e5.