摘要
目的探究替罗非班联合阿司匹林治疗老年进展性缺血性脑卒中(PIS)患者的临床效果及安全性。方法选择2017年2月至2020年8月六安市人民医院(安徽医科大学附属六安医院)收治的PIS患者116例作为研究对象,将患者随机分为对照组和观察组,各58例。所有患者均接受抗血小板聚集、改善循环、清除氧自由基、营养神经等对症支持治疗。所有患者均口服阿司匹林,观察组患者同时加用替罗非班,连续治疗2周后,比较2组患者的临床效果、神经功能缺损程度以及多项实验室指标。对所有患者进行90天的随访,比较随访期间2组患者不良反应的发生情况。结果观察组总有效率89.66%,对照组总有效率67.24%,差异具有统计学意义(P<0.05)。经治疗后,2组患者的美国国立卫生研究院卒中量表(NIHSS)评分均降低,观察组NIHSS评分为(5.41±1.62),对照组NIHSS评分为(8.86±1.79),差异具有统计学意义(P<0.05),观察组患者神经功能改善效果更佳。治疗结束后,观察组患者血浆黏度、血小板聚集率以及纤维蛋白原较对照组显著降低,分别为[(1.24±0.32)mPa/svs(1.68±0.36)mPa/s,P<0.001]、[(32.04±3.38)%vs(48.64±3.64)%,P<0.001]、[(2.26±0.48)g/Lvs(3.32±0.52)g/L,P<0.001]。随访的90天内,2组患者仅发生轻微出血,且发生率差异无统计学意义(P>0.05)。结论替罗非班联合阿司匹林治疗老年进展性缺血性脑卒中可有效提高治疗效果、改善神经功能,且安全性高。
ObjectiveTo evaluate the clinical efficacy and safety of tirofiban combined with aspirin in the treatment of elderly patients with progressive ischemic stroke(PIS).MethodsA total of 116 patients with PIS admitted to Lu'an Hospital Affiliated to Anhui Medical University&the People's Hospital of Lu'an from February 2017 to August 2020 were selected as the research subjects,and they were randomly divided into either a control group or an observation group,with 58 cases in each group.All patients received supportive treatments such as anti-platelet aggregation,improving circulation,scavenging oxygen free radicals,and nourishing nerves.All patients were given aspirin orally,and patients in the observation group were additionally given tirofiban at the same time.After 2 weeks of continuous treatment,the clinical effects,the degree of neurological impairment,and laboratory indicators were compared between the two groups.All patients were followed for 90 days to compare the occurrence of adverse reactions between the two groups during the follow-up period.ResultsAfter treatment,the total effective rate of the observation group was 89.66%,which was significantly higher than that of the control group(67.24%,P<0.05);the score of National Institute of Health stroke scale(NIHSS)in both groups was reduced,and the NIHSS score of the observation group(5.41±1.62)was significantly better than that of the control group(8.86±1.79,P<0.05);the improvement of neurological function was better in the observation group.After treatment,the plasma viscosity,platelet aggregation rate,and fibrinogen of the observation group were significantly lower than those of the control group[(1.24±0.32)mPa/svs(1.68±0.36)mPa/s,P<0.001;(32.04±3.38)%vs(48.64±3.64)%,P<0.001;(2.26±0.48)g/Lvs(3.32±0.52)g/L,P<0.001].Within 90 days of follow-up,only minor bleeding occurred in the two groups,and there was no significant difference in the incidence of adverse reactions.ConclusionTirofiban combined with aspirin can effectively improve the treatment effect and neurological function,and has high safety in the treatment of progressive ischemic stroke in the elderly.
作者
陈慧娟
陈然
金平
吴章松
刘勇
徐菲
赵启媛
Chen Huijuan;Chen Ran;Jin Ping;Wu Zhangsong;Liu Yong;Xu Fei;Zhao Qiyuan(Department of Neurology,Lu'an Hospital Affiliated to Anhui Medical University&Lu'an People's Hospital of Anhui Province,Lu'an 237000,China;Department of Neurology,Affiliated Hospital of West Anhui Health Vocational College,the Second People's Hospital of Lu'an,Lu'an 237000,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第12期922-927,共6页
Chinese Journal of Clinicians(Electronic Edition)
基金
2021年度安徽省卫生健康委科研项目(AHWJ2021b089)
