摘要
目的探讨丁苯酞联合替罗非班对急性进展性脑梗死(APCI)患者的疗效及预后的影响。方法选取75例APCI患者,均接受基础治疗联合丁苯酞和替罗非班治疗。观察治疗后美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数(BI),根据治疗后3个月改良Rankin量表(mRS)评分将患者分为预后良好组和预后不良组,采用单因素及多因素Logistic回归分析预后影响因素。结果治疗后,NIHSS评分和BI均较治疗前改善(P<0.05)。治疗3个月后,预后良好55例(73.3%),预后不良20例(26.7%)。多因素分析显示,合并冠心病、心房颤动、高NIHSS评分、大梗死病灶、呼吸衰竭及低白蛋白(ALB)水平是预后不良的独立危险因素(均P<0.05)。结论丁苯酞联合替罗非班可有效改善APCI患者神经功能及日常生活能力,其疗效受基础疾病、病情严重程度及ALB水平等因素影响。
Aim To investigate the efficacy and prognostic impact of butylphthalide combined with tirofiban in patients with acute progressive cerebral infarction(APCI).Methods A total of 75 APCI patients were enrolled and received standard treatment combined with butylphthalide and tirofiban.The National Institutes of Health Stroke Scale(NIHSS)score and Barthel Index(BI)were assessed before and after treatment.Based on the modified Rankin Scale(mRS)score at 3 months post-treatment,patients were divided into a favorable prognosis group(mRS 0-3)and a poor prognosis group(mRS 4-6).Univariate and multivariate Logistic regression analyses were performed to identify prognostic factors.Results After treatment,both NIHSS scores and BI significantly improved compared to baseline(P<0.05).At the 3-month follow-up,55 patients(73.3%)had a favorable prognosis,while 20(26.7%)had a poor prognosis.Multivariate analysis revealed that coronary heart disease,atrial fibrillation,higher baseline NIHSS score,large infarct size,respiratory failure,and low albumin(ALB)levels were independent risk factors for poor prognosis(all P<0.05).Conclusion Butylphthalide combined with tirofiban effectively improves neurological function and daily living ability in APCI patients.However,the treatment efficacy is influenced by comorbidities,disease severity,and ALB levels.
作者
石金铃
张坤
张玲玲
SHI Jinling;ZHANG Kun;ZHANG Lingling(Department of Neurology,Taihe County People's Hospital,Wannan Medical College Affiliated Taihe Hospital,Fuyang 236600,Anhui,China;Department of Neurology,Hangzhou First People's Hospital,Hangzhou 310006,Zhejiang,China)
出处
《中南医学科学杂志》
2025年第3期484-487,共4页
Medical Science Journal of Central South China
基金
浙江省医药卫生科研项目(2024KY1325)。
关键词
急性进展性脑梗死
丁苯酞
替罗非班
治疗效果
影响因素
acute progressive cerebral infarction
butylphthalide
tirofiban
treatment effect
prognostic factors
