替罗非班在急性脑梗死溶栓后再闭塞中的治疗价值及对vWF、sCD40L、NIHSS评分等的影响

目的:探讨替罗非班在急性脑梗死溶栓后再闭塞中的治疗价值及对血管性假友病因子(vWF)、血小板可溶性CD40配体(sCD40L)、NIHSS评分等的影响。方法:选取2018年2月至2019年2月在某院和外院联合接受治疗的急性脑梗死溶栓后再闭塞患者94例,根据治疗方案分为观察组(n=53)和对照组(n=41),对照组给予常规治疗,观察组在对照组基础上加用替罗非班治疗,观察治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、炎症因子、vWF和sCD40L等。结果:观察组溶栓后24h、出院时NIHSS评分分别为(5.89±0.83)分和(2.89±0.65)分,明显低于对照组(P<0.05);观察组治疗后白细胞介素-6(IL-6)、IL-8和高敏C反应蛋白(hs-CRP)分别为(67.39±23.10)ng·L^-1、(8.91±2.11)ng·L^-1和(10.03±2.11)mg·L^-1,明显低于对照组(P<0.05);观察组和对照组治疗前后vWF比较差异无统计学意义(P<0.05);观察组治疗后sCD40L为(44.39±5.93)mg·L^-1,明显低于对照组(P<0.05);两组不良事件发生率差异比较无统计学意义(P<0.05)。结论:替罗非班在急性脑梗死溶栓后再闭塞治疗中有较高的价值,对vWF、sCD40L影响较轻。

Therapeutic value of tirofiban in acute cerebral infarction after thrombolytic occlusion and its effect on vWF,sCD40L and NIHSS score

OBJECTIVE To investigate the therapeutic value of tirofiban in acute cerebral infarction after thrombolytic occlusion and its effect on von Willebrand factor (vWF), platelet soluble CD40 ligand (sCD40L) and NIHSS score.METHODS A total of 94 patients with reocclusion after thrombolysis for acute cerebral infarction who received combined treatment by our hospital and other hospital from February 2018 to February 2019 were selected and divided into observation group (n=53) and control group (n=41) according to treatment plan. The control group was given conventional treatment. The control group was treated with teicoplanin. The National Institutes of Health Stroke Scale (NIHSS) score, inflammatory factors, vWF and sCD40L were observed before and after treatment.RESULTS The NIHSS scores of the observation group at 24h after thrombolysis and at discharge were (5.89±0.83) and (2.89±0.65), which were significantly lower than those of the control group (P<0.05); After treatment, interleukin-6 (IL-6), IL-8 and hs-CRP in the observation group were (67.39±23.10) ng·L^-1, (8.91±2.11) ng·L^-1 and (10.03±2.11) mg·L^-1, which were significantly lower than those in the control group (P<0.05); There was no significant difference in vWF between the observation group and the control group before and after treatment (P<0.05); After treatment, sCD40L in the observation group was (44.39±5.93) μg·L^-1, which was significantly lower than that in the control group (P<0.05); There was no significant difference in the incidence of adverse events between the two groups (P<0.05).CONCLUSION Tirofiban has a higher value in the treatment of acute cerebral infarction after thrombolysis followed by occlusion, and has a relatively modest effect on vWF and sCD40L.