替罗非班对急性脑梗死静脉溶栓后24 h内神经功能恶化患者临床预后的影响

Effect of Tirofiban on Clinical Prognosis of Patients with Neurological Deterioration within 24 Hours after Intravenous Thrombolysis in Acute Cerebral Infarction

摘要: 目的：研究在急性脑梗死静脉溶栓后24 h神经功能恶化患者采用替罗非班治疗的效果。方法：选择2019年1月至2021年12月于烟台毓璜顶医院神经内科以及急诊内科住院经阿替普酶溶栓治疗后发生神经功能恶化脑梗死病患(纳入例数为122例)，将其视为本研究观察对象，按照有无应用药物替罗非班进行分组，其中观察组(应用药物替罗非班进行治疗，62例)、对照组(未应用药物替罗非班进行治疗，60例)，分析两组患者治疗前后各项指标的变化情况。结果：在经过治疗4 w、12 w后，观察组的神经功能缺损评分(NIHSS)均低于对照组，4 w后t = 14.751，12 w后t = 11.953，(P < 0.05)；观察组的改良Rankin量表(mRS)评分情况优于对照组(P < 0.05)；观察组的日常生活活动功能(ADL)评分高于对照组(P < 0.05)；观察组的临床治疗效果高于对照组(P < 0.05)；并且出血转化、血小板减少情况较之对照组更低，无统计学差异(P > 0.05)。结论：针对经过阿替普酶溶栓治疗后24 h出现神经功能恶化的脑梗死患者而言，采用替罗非班治疗能够有效改善其神经缺损情况，并减轻其功能障碍，加强活动功能的同时，维持良好的治疗效果，且用药安全可靠，值得研究和借鉴。

Abstract: Objective: To study the effect of tirofiban on patients with neurological deterioration in 24 hours after intravenous thrombolysis in acute cerebral infarction. Methods: From January 2019 to De-cember 2021, 122 patients with cerebral infarction with neurological deterioration who were hos-pitalized in the Department of Neurology and the Department of Emergency Medicine of Yantai Yuhuangding Hospital and treated with alteplase thrombolysis were selected as the study subjects. They were divided into the observation group and the control group according to whether tirofiban was used, which were 62 cases and 60 cases, respectively. The observation group was treated with Tirofiban, while the control group was not, the changes of various indexes of the two groups before and after treatment were analyzed. Results: After 4 and 12 weeks of treatment, the neurological deficit score (NIHSS) of the observation group was lower than that of the control group, with t = 14.751 after 4 weeks and t = 11.953 after 12 weeks (P < 0.05); The grading of the modified Rankin scale (mRS) in the observation group was better than that in the control group (P < 0.05); The score of ADL in the observation group was higher than that in the control group (P < 0.05); The clinical treatment effect of the observation group was higher than that of the control group (P < 0.05); The bleeding transformation and thrombocytopenia were lower than those in the control group, with no statistical difference (P > 0.05). Conclusion: For the patients with cerebral infarction whose neuro-logical function deteriorated 24 hours after the treatment of alteplase thrombolysis, the treatment of tirofiban can effectively improve their neurological deficit, reduce their dysfunction, enhance their activity function, maintain good therapeutic effect, and the drug is safe and reliable, which is worth studying and drawing lessons from.