替罗非班在缺血性进展性卒中的疗效观察
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摘要
目的观察盐酸替罗非班对缺血性进展性卒中的疗效。方法对300例符合进展性缺血性卒中标准的患者分成常规治疗组和替罗非班治疗组,其中常规治疗组给予强化抗血小板及强化降脂药物(PA2S方案,即普罗布考0. 5 g 2/d+硫酸氢氯吡格雷75 mg 1/d+阿司匹林100mg 1/d+阿托伐他汀40 mg 1/d),替罗非班组在PA2S方案的基础上,加用替罗非班,治疗后3天、1月及半年分别随访两组患者美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分,比较其组间差异。结果常规治疗组患者在治疗前、治疗3天、治疗1月及治疗半年时NIHSS评分分别为(11. 3±4. 2)分、(11. 5±4. 4)分、(8. 8±4. 1)分、(6. 1±4. 1)分;替罗非班组患者在治疗前、治疗3天、治疗1月及治疗半年时NIHSS评分分别为(11. 4±3. 9)分、(10. 8±3. 6)分、(7. 4±3. 2)分、(4. 4±3. 0)分。在治疗1月及半年时两组间有统计学差异(P <0. 01),替罗非班治疗优于常规治疗。结论盐酸替罗非班可改善进展性卒中患者神经功能缺损程度。
Objective To observe the efficacy of tirofiban in the treatment of ischemic progressive stroke. Methods 300 patients who met the diagnostic criteria of ischemic progressive stroke were divided into the control group and tirofiban group. Patients in the control group received treatment of PA2S regiment,i. e.,a combination of aspirin,clopidogrel,probucol and atorvastatin. Patients in the tirofiban group received extra tirofiban on the basis of PA2S therapy. National institute of health stroke scale( NIHSS) score was evaluated on patients in both group before the therapy and 3 days,1 month,6 months after the therapy respectively. Results For the control group,the average NIHSS score was 11. 3± 4. 2,11. 5 ± 4. 4,8. 8 ± 4. 1,6. 1 ± 4. 1 before therapy and at 3 days,1 month,6 months after the therapy. And for the tirofiban group,the average NIHSS score was 11. 4 ± 3. 9,10. 8 ± 3. 6,7. 4 ± 3. 2,4. 4± 3. 0 at the corresponding period respectively. There were statistical differences between the two groups in the period of 1 month and 6 months after treatment with P < 0. 001. Conclusions Tirofiban hydrochloride can improve the degree of neurological deficit and outcome in patients with ischemic progressive stroke.
Objective To observe the efficacy of tirofiban in the treatment of ischemic progressive stroke. Methods 300 patients who met the diagnostic criteria of ischemic progressive stroke were divided into the control group and tirofiban group. Patients in the control group received treatment of PA2S regiment,i. e.,a combination of aspirin,clopidogrel,probucol and atorvastatin. Patients in the tirofiban group received extra tirofiban on the basis of PA2S therapy. National institute of health stroke scale( NIHSS) score was evaluated on patients in both group before the therapy and 3 days,1 month,6 months after the therapy respectively. Results For the control group,the average NIHSS score was 11. 3± 4. 2,11. 5 ± 4. 4,8. 8 ± 4. 1,6. 1 ± 4. 1 before therapy and at 3 days,1 month,6 months after the therapy. And for the tirofiban group,the average NIHSS score was 11. 4 ± 3. 9,10. 8 ± 3. 6,7. 4 ± 3. 2,4. 4± 3. 0 at the corresponding period respectively. There were statistical differences between the two groups in the period of 1 month and 6 months after treatment with P < 0. 001. Conclusions Tirofiban hydrochloride can improve the degree of neurological deficit and outcome in patients with ischemic progressive stroke.
引文
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[10] Torgano G,Zecca B,Monzani V,et al. Effect of intravenous tirofiban and aspirin in reducing short-term and long-term neurologic deficit in patients with ischemic stroke:A double-blind randomized trial[J]. Cerebrovasc Dis,2010,29(3):275-281. DOI:10. 1159/000275503.
[2]李娟,黄东辉,王冲,等.辽宁省农村地区2013年脑卒中早死所致的疾病负担分析[J].中华疾病控制杂志,2017,21(3):255-260. DOI:10. 16462/j. cnki. zhjbkz. 2017. 03. 010.Li J,Huang DH,Wang C,et al. Analysis of the disease burden of stroke-related deaths among rural areas of Liaoning Province in2013[J]. Chin J Dis Control Prev,2017,21(3):255-260.DOI:10. 16462/j. cnki. zhjbkz. 2017. 03. 010.
[3]徐淑华,孙静,钱金明,等.脑卒中高危人群知信行调查及其影响因素分析[J].中华疾病控制杂志,2017,21(8):857-859. DOI:10. 16462/j. cnki. zhjbkz. 2017. 08. 025.Xu SH,Sun J,Qian JM,et al. Investigation and analysis of KAP among high risk population of stroke[J]. Chin J Dis Control Prev,2017,21(8):857-859. DOI:10. 16462/j. cnki. zhjbkz.2017. 08. 025.
[4] Del BA,Palumbo V,Lamassa M,et al. Progressive lacunar stroke:Review of mechanisms,prognostic features,and putative treatments[J]. Int J Stroke,2012,7(4):321-329. DOI:10.1111/j. 1747-4949. 2012. 00789. x
[5] Januzzi JL,Jr.,Snapinn SM,Di Battiste PM,et al. Benefits and safety of tirofiban among acute coronary syndrome patients with mild to moderate renal insufficiency:Results from the platelet receptor inhibition in ischemic syndrome management in patients limited by unstable signs and symptoms(prism-plus)trial[J].Circulation,2002,105(20):2361-2366.
[6] Siebler M,Hennerici MG,Schneider D,et al. Safety of tirofiban in acute ischemic stroke:The satis trial[J]. Stroke,2011,42(9):2388-2392. DOI:10. 1161/STROKEAHA. 110. 599662
[7] Junghans U,Seitz RJ,Aulich A,et al. Bleeding risk of tirofiban,a nonpeptide gpiib/iiia platelet receptor antagonist in progressive stroke:An open pilot study[J]. Cerebrovasc Dis,2001,12(4):308-312. DOI:10. 1159/000047726
[8] Adams HP Jr,Bendixen BH,Kappelle LJ,et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. Toast. Trial of org 10172 in acute stroke treatment[J]. Stroke,1993,24(1):35-41.
[9] Meyer BC,Hemmen TM,Jackson CM,et al. Modified national institutes of health stroke scale for use in stroke clinical trials:Prospective reliability and validity[J]. Stroke,2002,33(5):1261-1266.
[10] Torgano G,Zecca B,Monzani V,et al. Effect of intravenous tirofiban and aspirin in reducing short-term and long-term neurologic deficit in patients with ischemic stroke:A double-blind randomized trial[J]. Cerebrovasc Dis,2010,29(3):275-281. DOI:10. 1159/000275503.