摘要
目的 观察替罗非班对进展性脑梗死(PCI)患者预后的影响,为临床PCI的治疗提供依据。方法 选取2017年4月-2019年9月聊城市第二人民医院神经内科收治的入院后神经功能缺损症状逐渐加重的非大血管病变的PCI患者60例,按照随机数字表法分为观察组和对照组,每组30例。2组均进行基础用药治疗,对照组予以阿司匹林和氯吡格雷,观察组经上述治疗后,患者神经功能缺损症状逐渐加重,停用氯吡格雷,加用替罗非班持续泵入,待神经功能缺损症状未再加重24 h,停用替罗非班,口服氯吡格雷。比较2组患者神经功能缺损改善情况,治疗90 d时mRS评分各个分数的比例评价患者预后情况,以及不良反应。结果 治疗后2周、1个月、3个月时,观察组有效率均高于对照组,差异有统计学意义(P<0.05);治疗90 d时,观察组预后良好率为90. 00%,高于对照组的66. 67%(χ^(2)=4. 812,P=0. 028);2组均未发生明显不良反应。结论 PCI患者进展期应用替罗非班可改善患者神经功能缺损状态,降低患者残疾发生率,改善预后。
Objective To observe the effect of tirofiban on the prognosis of patients with progressive cerebral infarction(PCI),and to provide the basis for clinical PCI treatment.Methods From April 2017 to September 2019,60 cases of PCI patients with neurological deficit symptoms gradually aggravated after admission in Department of Neurology of the Second People's Hospital of Liaocheng were selected and randomly divided into observation group and control group,30 cases in each group.Both groups were treated with basic medications.The control group was given aspirin and clopidogrel.After the above treatments,the patients in the observation group gradually worsened their neurological deficits.Clopidogrel was stopped and tirofiban was continuously pumped.The symptoms of functional impairment did not worsen for 24 hours.Tirofiban was discontinued and clopidogrel was taken orally.The improvement of neurological deficits in the two groups was compared,and the ratio of each score of the mRS score at 90 days of treatment was used to evaluate the prognosis and adverse reactions of the patients.Results At 2 weeks,1 month,and 3 months after treatment,the effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).90 days of treatment,the good prognosis rate of the observation group was 90.00%,which was higher than the 66.67%of the control group(χ^(2)=4.812,P=0.028).No obvious adverse reactions occurred in the two groups.Conclusion Tirofiban can reduce neurological deficit score,reduce the incidence of disability and improve prognosis in patients with advanced PCI.
作者
潘伟
王永红
鲍景蕾
常万生
林峰
赵延军
PAN Wei;WANG Yonghong;BAO Jinglei(Department of Neurology,Liaocheng Second Hospital Affiliated to Shandong First Medical University/the Second People's Hospital of Liaocheng,Shandong Province,Linqing 252600,China)
出处
《临床合理用药杂志》
2021年第26期8-9,13,共3页
Chinese Journal of Clinical Rational Drug Use
