替罗非班对急性缺血性脑卒中血管内治疗患者神经功能及术后出血转化的影响

目的探讨替罗非班对急性缺血性脑卒中(AIS)血管内治疗患者神经功能及术后出血转化的影响。方法我院收治的120例AIS患者,根据是否应用替罗非班分为对照组58例和观察组62例,对照组给予静脉溶栓桥接血管内治疗,观察组在对照组基础上加用替罗非班治疗,比较两组治疗14 d的神经功能美国国立卫生研究院卒中量表(NIHSS)、血小板功能指标(血小板聚集率、血小板黏附率及P-选择素)和炎症指标超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6),治疗90 d的预后改良Rankin量表问卷(mRS)和日常生活能力(Barthel指数)、不良事件情况。结果治疗14 d内,两组NIHSS评分均降低,且观察组治疗24 h、7 d、14 d的NIHSS评分均低于对照组(P<0.05);治疗14 d后,两组血小板功能指标、炎症指标水平均降低,且观察组低于对照组(P<0.05);治疗90 d后,两组mRS评分降低,Barthel指数评分提高,且观察组治疗后的mRS评分低于对照组,Barthel指数评分高于对照组(P<0.05);治疗后90 d内,观察组血管再闭塞率低于对照组(P<0.05),两组症状性颅内出血转化、非症状性颅内出血转化、其他部位出血及死亡发生率比较差异无统计学意义(P>0.05)。结论AIS患者血管内治疗时应用替罗非班有助于的患者神经功能、血小板功能的改善及炎症状态的减轻,可改善患者预后、提高其日常生活能力,而对术后出血转化并无明显不良影响。

Effects of tirofiban on neurological function and postoperative hemorrhagic transformation in patients with acute ischemic stroke undergoing endovascular treatment

Objective To explore the effects of tirofiban on neurological function and postoperative hemorrhagic transformation in patients with acute ischemic stroke(AIS)undergoing endovascular treatment.Methods Clinical data of 120 patients with AIS were retrospectively analyzed.According to whether the patients were treated with tirofiban,they were divided into control group(n=52)and observation group(n=62).The control group was treated with intravenous thrombolysis bridging endovascular treatment while the observation group was additionally given tirofiban on the basis of the control group.The neurological function estimated by using National Institutes of Health Stroke Scale(NIHSS),platelet function indicators such as platelet aggregation rate,platelet adhesion rate and P-selectin,and inflammation indicators such as high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)after 14 days of treatment were compared between the two groups.The prognosis estimated by using Modified Rankin Scale(mRS),ability of daily living(Barthel index)and adverse events after 90 days of treatment were also compared between the two groups.Results Within 14 days of treatment,the NIHSS scores of the two groups were reduced,and the NIHSS scores in the observation group were lower than those in the control group after 24 h,7 days and 14 days of treatment(P<0.05).After 14 days of treatment,the platelet function indicators and inflammation indicators were decreased in the two groups,and the indicators in the observation group were lower than those in control group(P<0.05).After 90 days of treatment,the mRS scores of the two groups were decreased while the Barthel index scores were increased,and the mRS score after treatment was lower while the Barthel index score was higher in the observation group than those in control group(P<0.05).Within 90 days after treatment,the vascular reocclusion rate in the observation group was lower than that in the control group(P<0.05),but there were no significant differences in the incidence rates of symptomatic intracranial hemorrhagic transformation,non-symptomatic intracranial hemorrhagic transformation and other site hemorrhage as well as death between the two groups(P>0.05).Conclusion Tirofiban during endovascular treatment of patients with AIS can help improve the neurological function and platelet function,and relieve the inflammatory status.It can improve the prognosis and enhance the ability of daily living.However,it has no significant adverse effect on postoperative hemorrhagic transformation.