摘要
目的探讨替罗非班联合奥扎格雷钠对进展性缺血性脑卒中(PIS)患者神经功能和血小板功能的影响。方法选取南阳市镇平县人民医院神经内科2013年6月—2015年6月收治的PIS患者80例,采用随机数字表法分为对照组和治疗组,每组40例。对照组患者在常规治疗基础上给予奥扎格雷钠联合安慰剂(0.9%氯化钠溶液)治疗,治疗组患者在常规治疗基础上给予奥扎格雷钠联合替罗非班治疗,两组患者均连续治疗14 d。采用美国国立卫生研究院卒中量表(NIHSS)评分、神经功能缺损程度量表(NDS)评分、日常生活活动能力(ADL)评分评估患者神经功能,采用旋转波球法检测血小板黏附率,采用比浊法检测血小板聚集率,采用流式细胞术检测CD62p、CD63表达水平,采用酶联免疫吸附试验检测P选择素(P-selectin)水平。比较两组患者治疗前后神经功能、血小板功能及治疗后临床疗效、治疗期间不良反应发生情况。结果治疗前两组患者NIHSS评分、NDS评分及ADL评分比较,差异无统计学意义(P>0.05);治疗后治疗组患者NIHSS评分和NDS评分低于对照组,ADL评分高于对照组(P<0.05);且治疗后两组患者NIHSS评分和NDS评分低于治疗前,ADL评分高于治疗前(P<0.05)。治疗前两组患者血小板黏附率、血小板聚集率、CD62p表达水平、CD63表达水平及P-selectin水平比较,差异无统计学意义(P>0.05);治疗后治疗组患者血小板黏附率、血小板聚集率、CD62p表达水平、CD63表达水平及P-selectin水平低于对照组(P<0.05);治疗后两组患者血小板黏附率、血小板聚集率、CD62p表达水平、CD63表达水平及P-selectin水平低于治疗前(P<0.05)。治疗组患者临床疗效优于对照组(u=3.451,P<0.05)。治疗期间两组患者均未发生严重不良反应。结论替罗非班联合奥扎格雷钠治疗PIS的临床疗效确切,能有效改善患者神经功能、抑制血小板活化功能,且安全性较高。
Objective To investigate the impact of tirofiban combined with sodium ozagrel on neurological function and platelet functions of patient with progressive ischemic stroke. Methods From June 2013 to June 2015,a total of 80 patients with progressive ischemic stroke were selected in the Department of Neurology, the People＇ s Hospital of Zhenping County,Nanyang,and they were divided into control group and treatment group according to random number table, each of 40 cases. Based on conventional treatment,patients of control group received sodium ozagrel combined with 0. 9% sodium chloride injection,while patients of treatment group received tirofiban combined with sodium ozagrel; both groups continuously treated for14 days. NIHSS score,NDS score and ADL score were used to evaluate the neurological function,rotating wave ball method was used to detect the platelet adhesion rate,turbidimetry was used to detect the platelet aggregation rate,flow cytometry was used to detect expressions of CD62 p and CD63,enzyme linked immunosorbent assay was used to detect the P-selectin level. Neurological function and platelet functions before and after treatment,clinical effect and incidence of adverse reactions during treatment were compared between the two groups. Results No statistically significant differences of NIHSS score,NDS score or ADL score was found between the two groups before treatment（ P〈0. 05）; after treatment, NIHSS score and NDS score of treatment group were statistically significantly lower than those of control group,while ADL score of treatment group was statistically significantly higher than that of control group（ P〈0. 05）. After treatment,NIHSS score and NDS score of the two groups were statistically significantly lower than those before treatment,while ADL score of the two group was statistically significantly higher than that before treatment（ P〈0. 05）. No statistically significant differences of platelet adhesion rate, platelet aggregation rate,expression of CD62 p or CD63, or P-selectin
出处
《实用心脑肺血管病杂志》
2016年第4期35-39,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
卒中
替罗非班
奥扎格雷钠
神经功能
血小板功能
Stroke
Tirofiban
Sodium ozagrel
Neurological function
Platelet function
