摘要
目的研究替罗非班联合依达拉奉对急性脑梗死(ACI)患者血小板功能、脑血流量及氧化应激指标的影响。方法选取2018年8月至2020年10月河南省胸科医院神经内科收治的126例ACI患者进行前瞻性研究,以随机数表法分为观察组和对照组,每组63例。对照组患者在常规治疗基础上给予依达拉奉治疗,观察组在对照组基础上再给予替罗非班治疗,均治疗2周。比较两组患者的临床疗效以及治疗前、治疗1周、2周后的血小板功能指标[血小板聚集率(PAgT)、血小板黏附率(PAdT)、血小板P选择素(P-selectin)]、脑血流量指标[大脑中动脉的平均血流速度(V_(m))、收缩期峰值血流速度(V_(s))、舒张末期血流速度(V_(d))]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-px)]水平、神经功能缺损程度评分(NIHSS)和日常生活能力评分(BI),并统计治疗期间不良反应发生情况。结果观察组患者治疗2周后的总有效率为93.65%,明显高于对照组的79.37%,差异有统计学意义(P<0.05);两组患者治疗1周、2周后的PAgT、PAdT、P-selectin水平与NIHSS评分均较本组治疗前降低,且组间比较观察组各时间点均低于对照组,V_(m)、V_(s)、V_(d)水平与BI评分均较本组治疗前提高,且组间比较观察组各时间点均高于对照组,差异均有统计学意义(P<0.05);两组患者治疗1周、2周后的血清SOD、GSH-px水平均较本组治疗前提高,且组间比较观察组各时间点均较对照组高,MDA水平均较本组治疗前降低,且组间比较观察组各时间点均较对照组低,差异均有统计学意义(P<0.05);观察组和对照组患者治疗期间的不良反应发生率分别为11.11%与6.35%,组间比较差异无统计学意义(P>0.05)。结论替罗非班联合依达拉奉治疗ACI可改善患者的血小板功能与脑血流量,减轻氧化应激反应与神经功能缺损程度,提高日常生活能力,临床治疗效果显著且安全性好。
Objective To study the effects of tirofiban combined with edaravone on platelet function,cerebral blood flow,and oxidative stress indicators in patients with acute cerebral infarction(ACI).Methods From August 2018 to October 2020,126 ACI patients admitted to the Department of Neurology at Henan Provincial Chest Hospital were selected for prospective study.They were divided into an observation group and a control group by random number table,with 63 patients in each group.The patients in the control group were treated with edaravone on the basis of the conventional treatment,and the observation group were treated with tirofiban on the basis of the control group.Both were treated for 2 weeks.The clinical efficacy were compared between the two groups,also as well as a series of indicators before treatment,1 week,and 2 weeks after treatment,including platelet function indexes(platelet aggregation rate[PAgT],platelet adhesion rate[PAdT],platelet P-selectin),cerebral blood flow indexes(mean blood flow velocity in middle cerebral artery[V_(m)],peak systolic blood flow velocity[V_(s)],end-diastolic blood flow velocity[V_(d)]),the levels of oxidative stress indicators(superoxide dismutase[SOD],malondialdehyde[MDA],glutathione peroxidase[GSH-px]),NIH stroke scale(NIHSS)for assessing neurological deficit,Barthel index(BI)score for measuring the activities of daily living;and the occurrence of adverse reactions were counted during the treatment.Results The total effective rate of patients in the observation group after 2 weeks of treatment was 93.65%,which was significantly higher than the 79.37%in the control group,and the difference was statistically significant(P<0.05).The levels of PAgT,PAdT,P-selectin,and NIHSS scores of the two groups were all lower after 1 week and 2 weeks of treatment than before treatment,and the comparison between the groups was lower in the observation group than in the control group at each time point;the levels of V_(m),V_(s),V_(d),and BI scores were higher than those of this group before treatment,and the comparison between the groups was higher in the observation group than in the control group at each time points,with statistically significant differences(P<0.05).The serum levels of SOD and GSH-px in the two groups were higher after 1 week and 2 weeks of treatment than before treatment,and the comparison between the groups was higher in the observation group than in the control group at each time point;the MDA level was lower than that before treatment in this group,and the comparison between the groups was lower in the observation group than in the control group at each time point,with statistically significant differences(P<0.05).The incidence of adverse reactions was 11.11%in the observation group and 6.35%in the control group during treatment,and there was no statistically significant difference between the groups(P>0.05).Conclusion Tirofiban combined with edaravone in the treatment of ACI can improve the patient's platelet function and cerebral blood flow,reduce the degree of oxidative stress and neurological deficit,and improve the ability of daily living.The clinical treatment effect is significant and the safety is good.
作者
司亚克
赵祚翔
SI Ya-ke;ZHAO Zuo-xiang(Department of Neurology,Henan Provincial Chest Hospital,Zhengzhou 450000,Henan,CHINA;Department of Neurology,Zhengzhou People's Hospital,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2021年第11期1387-1391,共5页
Hainan Medical Journal
关键词
急性脑梗死
替罗非班
依达拉奉
血小板功能
脑血流量
氧化应激
Acute cerebral infarction
Tirofiban
Edaravone
Platelet function
Cerebral blood flow
Oxidative stress
