摘要
目的观察超溶栓时间窗的进展性卒中患者应用替罗非班持续泵入治疗后的有效性和安全性。方法选取2018年4月至2020年4月神经内科住院的发生急性进展性卒中患者126例,随机分为治疗组和对照组,每组63例。对照组在常规对症治疗基础上予阿司匹林、氯吡格雷治疗。治疗组在常规对症治疗基础上给予盐酸替罗非班静脉泵入治疗,后给予阿司匹林氯吡格雷治疗。观察患者在替罗非班治疗后24 h、3 d、7 d的神经功能缺损情况及日常生活能力改善情况,采用美国国立卫生研究院卒中量表(NIHSS评分)进行神经功能缺损评分,Barthel指数(BI)评分进行日常生活能力(ADL)评分。评估替罗非班的临床有效性及患者用药7 d内不良反应发生情况,包括血小板减少、过敏情况、有无出血转化或继发脑实质出血等。结果治疗组总有效率为90.5%高于对照组的69.8%,差异有统计学意义(P<0.05)。治疗组在基本痊愈率、显著改善率、好转率方面均高于对照组(P<0.05),无效率低于对照组(P<0.05)。2组患者治疗7 d后NIHSS评分及ADL评分与治疗前和对照组比较有显著改善(P<0.05)。替罗非班治疗后的24 h、3 d、7 d,治疗组的NIHSS评分较治疗前显著降低,且低于对照组(P<0.05)。患者日常生活能力量表评分中,治疗组ADL评分显著提高,且高于对照组(P<0.05)。治疗组总不良反应发生率为23.8%,对照组为15.9%。2组总不良反应发生率差异无统计学意义(P>0.05)。结论替罗非班超溶栓时间窗的进展性卒中患者效果显著,可改善患者神经功能缺损情况及提高生活质量,且不增加出血风险,有较好的临床有效性和安全性。
Objective To investigate the effectiveness and safety of tirofiban in advanced stroke patients with hyperthrombolytic time window.Methods A total of 126 patients with acute progressive stroke who were treated in our hospital from April 2018 to April 2020 were enrolled in the study,who were randomly divided into observation group and control group,with 63 cases in each group.The patients in control group were treated by aspirin and clopidogrel on the basis of conventional symptomatic treatment,however,the patients in observation group,on the basis of conventional therapy,were treated by intravenous infusion of tirofiban hydrochloride via intravenous pump,followed by clopidogrel and aspirin.The neurological deficits and the improvement of the daily living ability of the patients at 24h,3d and 7d after treatment,and the neurological deficits by the National Institutes of Health Stroke Scale(NIHSS)score,and the Barthel Index(BI)score,daily living ability(ADL),and the clinical efficacy as well as the incidence of adverse reactions were observed and compared between the two groups.Results The total clinical effective rate in observation group was significantly higher than that in control group(90.5%vs 69.8%,P<0.05).The basic recovery rate,significant improvement rate and improvement rate in observation group were superior to those in control group(P<0.05),but the inefficiency in observation group was significantly lower than that in control group(P<0.05).After 7-day treatment,the NIHSS scores and ADL scores in both groups were significantly improved(P<0.05).At 24h,3d and 7d after tirofiban treatment,the NIHSS score in observation group were significantly lower than those before treatment,and those in control group(P<0.05).And the ADL scores in observation group were significantly increased,which were significantly higher than those in control group(P<0.05).Moreover the total incidence of adverse reactions in observation group was 23.8%,which was 15.9%in control group,there was no significant difference between the two groups(P>0.05).Conclusion The curative effects of tirofiban in treatment of progressive stroke with thrombolytic time window are significant,which can improve the neurological deficit and quality of life of patients without increasing the risk of bleeding,with better effectiveness and safety.
作者
吴海威
隋丽
吴萌萌
WU Haiwei;SUI Li;WU Mengmeng(Department of Neurology,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;不详)
出处
《河北医药》
CAS
2022年第5期747-750,共4页
Hebei Medical Journal
基金
首都医科大学大兴教学医院院级课题立项项目(编号:4202026334)。
