摘要
目的研究肝素联合替罗非班治疗醒后卒中的临床疗效及对患者血小板功能和炎症因子水平的影响。方法前瞻性选取2021年1月至2024年6月邢台市中心医院收治的醒后卒中患者80例作为研究对象,按照随机数字表法将其分为对照组(n=40)和研究组(n=40)。对照组患者口服阿司匹林治疗,研究组患者皮下注射低分子肝素和静脉滴注替罗非班治疗,两组均治疗2周。比较两组患者治疗疗效,治疗前和治疗2周后的美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)量表评分、血小板聚集率、血小板黏附率、血清炎症因子[肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)]水平以及治疗期间不良反应发生情况。结果研究组的总有效率为80.00%,显著高于对照组(57.50%),差异有统计学意义(P<0.05)。治疗2周后,两组的NIHSS评分均较治疗前明显降低,ADL评分均较治疗前明显升高,且研究组NIHSS评分为(5.03±0.82)分,低于对照组[(7.15±1.24)分],ADL评分为(76.29±7.78)分,高于对照组[(65.57±6.42)分],差异均有统计学意义(P<0.05)。治疗2周后,两组患者血小板聚集率和血小板黏附率均较治疗前明显降低,且研究组血小板聚集率和血小板黏附率分别为(35.01±3.97)%、(29.26±2.72)%,均低于对照组[(37.38±3.42)%、(31.36±3.02)%],差异均有统计学意义(P<0.05)。治疗2周后,两组的血清TNF-α、IL-6水平均较治疗前明显降低,且研究组血清TNF-α、IL-6水平分别为(7.02±1.06)、(55.17±7.42)ng/L,均低于对照组[(9.36±1.84)、(62.97±8.74)ng/L],差异均有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论肝素联合替罗非班治疗醒后卒中患者临床疗效较好,能有效改善患者血小板功能,降低血清炎症因子水平和提高患者生活活动能力。
Objective To study the clinical efficacy of heparin combined with tirofiban in the treatment of stroke after wake-up and its effect on platelet function and serum inflammatory factor levels.Methods A total of 80 patients with wake-up stroke who were treated in Xingtai Central Hospital from January 2021 to June 2024 were prospectively selected as subjects.They were divided into the control group(n=40)and the study group(n=40)according to the random number table method.Patients in the control group were treated with oral aspirin,while the patients in the study group were treated with subcutaneous injection of low molecular weight heparin and intravenous infusion of tirofiban,both groups treated for 2 weeks.The treatment efficacy,National Institutes of Health Stroke Scale(NIHSS)score,activity of daily living(ADL)scale score,platelet aggregation rate,platelet adhesion rate,serum inflammatory factor[tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]levels before treatment and 2 weeks after treatment,and incidence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the study group was 80.00%,which was significantly higher than that of the control group(57.50%),the difference was statistically significant(P<0.05).After 2 weeks of treatment,the NIHSS scores of the two groups were significantly lower than those before treatment,and the ADL scores were significantly higher than those before treatment.The NIHSS score of the study group was(5.03±0.82)points,which was lower than that of the control group[(7.15±1.24)points],and the ADL score was(76.29±7.78)points,which was higher than that of the control group[(65.57±6.42)points],the differences were statistically significant(P<0.05).After 2 weeks of treatment,the platelet aggregation rate and platelet adhesion rate of the two groups were significantly lower than those before treatment,and the platelet aggregation rate and platelet adhesion rate of the study group were(35.01±3.97)%and(29.26±2.72)%,respectively,which were lower than those of the control group[(37.38±3.42)%,(31.36±3.02)%],the differences were statistically significant(P<0.05).After 2 weeks of treatment,the levels of serum TNF-αand IL-6 in the two groups were significantly lower than those before treatment,and the levels of serum TNF-αand IL-6 in the study group were(7.02±1.06)and(55.17±7.42)ng/L,respectively,which were lower than those in the control group[(9.36±1.84)and(62.97±8.74)ng/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Heparin combined with tirofiban has good clinical efficacy in the treatment of stroke patients after wake-up,effectively improving platelet function,reducing serum inflammatory factor levels and improving life ability.
作者
刘亚林
郭医杰
孟文娟
孔咏梅
袁莹
LIU Ya-lin;GUO Yi-jie;MENG Wen-juan(Department of Neurology,Xingtai Central Hospital,Xingtai Hebei 054000,China)
出处
《临床和实验医学杂志》
2025年第10期1020-1024,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫生计生委科技项目(编号:1120140236)
邢台市科技计划项目(编号:2017ZC077)。
关键词
卒中
肝素
血小板
替罗非班
炎症因子
Stroke
Heparin
Blood platelets
Tirofiban
Inflammatory factor
