替罗非班联合强化降脂在后循环急性脑梗死超时间窗救治中的有效性和安全性研究

Study on efficacy and safety of tirofiban combined with intensive lipid-lowering therapy in treatment of acute cerebral infarction of posterior circulation beyond time window

摘要:

目的 观察替罗非班联合强化降脂在后循环急性脑梗死超时间窗救治中的有效性和安全性。方法 选取2020年6月—2022年2月海南西部中心医院收治的106例后循环急性脑梗死超时间窗患者，按随机数字表法分为对照组和实验组。对照组给予强化降脂治疗，实验组给予替罗非班联合强化降脂治疗。两组患者均连续治疗2周，比较两组的治疗效果及药物不良反应发生情况。结果 研究过程中共脱落4例。治疗后实验组美国国立卫生院卒中量表评分高于对照组（P <0.05）；实验组的总有效率高于对照组（P <0.05）；治疗后实验组的血浆黏度、全血高切黏度和全血低切黏度水平均低对照组（P <0.05）；实验组治疗后凝血酶原时间、凝血酶时间和活化部分凝血酶时间与对照组比较，差异均无统计学意义（P >0.05）。实验组治疗后肿瘤坏死因子、白细胞介素-6、丙二醛和超氧化物歧化酶均低对照组（P <0.05）；实验组治疗后血管内皮生长因子、内皮素-1和一氧化氮水平均低对照组（P <0.05）；两组不良反应发生率，差异无统计学意义（P >0.05）。结论 替罗非班联合强化降脂用于救治后循环急性脑梗死超时间窗患者效果较好。

Abstract:

Objective To observe the efficacy and safety of tirofiban combined with enhanced lipid-lowering in the treatment of acute cerebral infarction in the posterior circulation beyond the time window.Methods Totally 106 patients with posterior circulation acute cerebral infarction exceeding the time window were divided into control group and treatment group by random number table. The control group was given intensive lipid-lowering treatment, and the treatment group was given tirofiban combined with intensive lipid-lowering treatment. The two groups of patients were treated continuously for 2 weeks, and the treatment effect and adverse drug reactions were compared.Results A total of 4 cases fell off during the experiment. After treatment, the NIHSS score of experimental group was higher than that of control group (P < 0.05). The total effective rate of experimental group was higher than that of control group (P < 0.05). Plasma viscosity (PV), Whole Blood High Tangential Viscosity (HSV) and Whole Blood Low tangential Viscosity (LSV) of experimental group were low in control group after treatment (P < 0.05). There were no significant differences in PT, TT and APTT levels between experimental group and control group after treatment (P > 0.05). The levels of TNF-α, IL-6, MDA and SOD in experimental group were low in control group after treatment (P < 0.05). The levels of vascular endothelial growth factor (VEGF), endothelin-1 (ET-1) and nitric oxide (NO) in experimental group were low in control group after treatment (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).Conclusion Tirofiban combined with intensive lipid-lowering therapy is effective in the treatment of patients with acute cerebral infarction of posterior circulation beyond the time window.