替罗非班在急性脑卒中溶栓后再闭塞患者治疗中的价值与安全性分析
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摘要
目的探讨替罗非班在急性脑卒中溶栓后再闭塞患者治疗中的价值与安全性。方法按照治疗方案不同将溶栓治疗后再闭塞的80例急性脑卒中患者分为观察组和对照组各40例,对照组给予依诺肝素治疗,观察组给予替罗非班治疗,比较两组患者的治疗效果及安全性。结果两组患者的治疗总有效率比较差异无明显统计学意义(P>0.05),但观察组患者的基本治愈率显著高于对照组(P<0.05);观察组溶栓后24 h及溶栓后1周的NIHSS评分均显著低于对照组,差异有统计学意义(均P<0.05);两组患者溶栓后24 h的凝血功能指标水平以及不良事件发生率比较,差异无明显统计学意义(P>0.05)。结论替罗非班治疗急性脑卒中溶栓后再闭塞的疗效显著,可明显改善患者神经功能,且不良事件发生率低,对凝血功能无影响,值得临床应用。
Objective To investigate the value and safety of tirofiban in the treatment of patients with reocclusion after thrombolysis in acute stroke. Methods According to different treatment regimens,80 patients with acute stroke who were occluded after thrombolytic therapy were divided into 40 patients in the observation group and 40 patients in the control group.The patients in the control group were treated with enoxaparin,and the patients in the observation group were treated with tirofiban.The efficacy and safety of the two groups of patients were compared. Results There was no significant difference in the total effective rate between the two groups(P> 0.05),but the basic cure rate of the observation group was significantly higher than that of the control group(P< 0.05).The observation group had the NIHSS score at 24 h after thrombolysis and 1 week after thrombolysis,which was significantly lower than those of the control group at the same time(P< 0.05 for both).There was no significant difference in the level of coagulation function and the incidence of adverse events between the two groups after thrombolysis(P> 0.05). Conclusion Tirofiban is effective in reocclusion after thrombolysis in acute stroke,which can significantly improve the neurological function of patients.The incidence of adverse events is low and will not significantly affect the coagulation function of patients.It is worthy of clinical recommendation.
Objective To investigate the value and safety of tirofiban in the treatment of patients with reocclusion after thrombolysis in acute stroke. Methods According to different treatment regimens,80 patients with acute stroke who were occluded after thrombolytic therapy were divided into 40 patients in the observation group and 40 patients in the control group.The patients in the control group were treated with enoxaparin,and the patients in the observation group were treated with tirofiban.The efficacy and safety of the two groups of patients were compared. Results There was no significant difference in the total effective rate between the two groups(P> 0.05),but the basic cure rate of the observation group was significantly higher than that of the control group(P< 0.05).The observation group had the NIHSS score at 24 h after thrombolysis and 1 week after thrombolysis,which was significantly lower than those of the control group at the same time(P< 0.05 for both).There was no significant difference in the level of coagulation function and the incidence of adverse events between the two groups after thrombolysis(P> 0.05). Conclusion Tirofiban is effective in reocclusion after thrombolysis in acute stroke,which can significantly improve the neurological function of patients.The incidence of adverse events is low and will not significantly affect the coagulation function of patients.It is worthy of clinical recommendation.
引文
[1] 邵晓.脑梗死溶栓后早期血管再闭塞的临床分析[J].中国医药指南,2012,10(19):137-138.
[2] 刘家敏,陈正挪,崔景修,等.干预急性脑梗死尿激酶静脉溶栓后再闭塞的临床研究[J].中风与神经疾病杂志,2012,29(11):1027-1029.
[3] 潘鹏克.替罗非班在急性缺血性脑卒中的应用及研究进展[J].中国处方药,2018,16(5):17-18.
[4] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[5] Lee CF,Venketasubramanian N,Wong KS,et al.Comparison Between the Original and Shortened Versions of the National Institutes of Health Stroke Scale in Ischemic Stroke Patients of Intermediate Severity [J].Stroke,2016,47(1):236-239.
[6] 张建,付慧霄,孙艳军.应用R-TPA溶栓治疗脑梗死病人溶栓后血管再闭塞的临床特点[J].中国老年学杂志,2016,36(8):1868-1869.
[7] 符俊骐,史克珊,夏鹰.急性脑梗死动脉溶栓术后并发症临床分析[J].海南医学,2014,25(1):78-79.
[8] 杨槐枫.急性脑梗死溶栓治疗后再闭塞原因探讨[J].中国社区医师(医学专业),2012,14(32):142-143.
[9] 陈友芹.低分子肝素钙在急性脑梗死患者静脉溶栓后血管再闭塞治疗中的应用价值[J].河南医学研究,2017,26(13):2380-2381.
[10] 李坷,张继中,张钦昌.国产替罗非班在急性进展性脑梗死治疗中的应用[J].中国实用神经疾病杂志,2017,20(1):117-118.
[11] 孙原,石秋艳,李艳玲,等.替罗非班治疗阿替普酶静脉溶栓后再闭塞的疗效观察[J].中国实用神经疾病杂志,2018,21(1):40-43.
[12] 杨金波,马晓丹,马晓辉,等.尿激酶联合替罗非班治疗基底动脉闭塞再通二例[J].脑与神经疾病杂志,2017,25(12):776-780.
[2] 刘家敏,陈正挪,崔景修,等.干预急性脑梗死尿激酶静脉溶栓后再闭塞的临床研究[J].中风与神经疾病杂志,2012,29(11):1027-1029.
[3] 潘鹏克.替罗非班在急性缺血性脑卒中的应用及研究进展[J].中国处方药,2018,16(5):17-18.
[4] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[5] Lee CF,Venketasubramanian N,Wong KS,et al.Comparison Between the Original and Shortened Versions of the National Institutes of Health Stroke Scale in Ischemic Stroke Patients of Intermediate Severity [J].Stroke,2016,47(1):236-239.
[6] 张建,付慧霄,孙艳军.应用R-TPA溶栓治疗脑梗死病人溶栓后血管再闭塞的临床特点[J].中国老年学杂志,2016,36(8):1868-1869.
[7] 符俊骐,史克珊,夏鹰.急性脑梗死动脉溶栓术后并发症临床分析[J].海南医学,2014,25(1):78-79.
[8] 杨槐枫.急性脑梗死溶栓治疗后再闭塞原因探讨[J].中国社区医师(医学专业),2012,14(32):142-143.
[9] 陈友芹.低分子肝素钙在急性脑梗死患者静脉溶栓后血管再闭塞治疗中的应用价值[J].河南医学研究,2017,26(13):2380-2381.
[10] 李坷,张继中,张钦昌.国产替罗非班在急性进展性脑梗死治疗中的应用[J].中国实用神经疾病杂志,2017,20(1):117-118.
[11] 孙原,石秋艳,李艳玲,等.替罗非班治疗阿替普酶静脉溶栓后再闭塞的疗效观察[J].中国实用神经疾病杂志,2018,21(1):40-43.
[12] 杨金波,马晓丹,马晓辉,等.尿激酶联合替罗非班治疗基底动脉闭塞再通二例[J].脑与神经疾病杂志,2017,25(12):776-780.