替罗非班序贯双联抗血小板治疗在进展性缺血性脑卒中的应用效果OA
Clinical Efficacy of Tirofiban Sequential Dual Antiplatelet Therapy in Progressive Ischemic Stroke
目的:评估替罗非班序贯双联抗血小板治疗(双抗治疗)在进展性缺血性脑卒中患者中的临床效果及对神经功能的影响.方法:采用前瞻性随机对照研究设计,选取 2024 年 8 月—2025 年 11 月广东医科大学附属第二医院神经内科收治的 160 例进展性缺血性脑卒中患者,通过随机数字表法将其分为对照组(80 例,采用阿司匹林联合硫酸氢氯吡格雷双抗治疗)和研究组(80 例,采用替罗非班序贯双联抗血小板治疗),两组均接受统一的缺血性脑卒中基础治疗,比较两组患者治疗后的总体疗效、神经功能缺损程度、日常生活能力、炎症因子水平及血小板功能指标的变化,同时记录治疗期间的不良反应发生率.结果:研究组治疗第 90 天的总有效率为 93.75%,显著高于对照组的 77.50%(P<0.05).两组治疗第 7、30、90 天的NIHSS评分均较治疗前显著下降,BI评分均显著上升,且研究组NIHSS评分低于对照组,BI评分高于对照组(P<0.05).研究组治疗第 7 天炎症因子(TNF-α、IL-6、hs-CRP)水平均低于对照组,血小板活化指标[血小板α-颗粒膜蛋白 140(GMP-140)、血栓烷B2(TXB2)]水平低于对照组(P<0.05).两组不良反应发生率比较差异无统计学意义(P>0.05).结论:对于进展性缺血性脑卒中患者,在标准双抗治疗基础上序贯应用替罗非班,能够更有效地改善神经功能缺损,提升日常生活能力,且未显著增加不良反应风险.
Objective:To evaluate the clinical efficacy of Tirofiban sequential dual antiplatelet therapy in patients with progressive ischemic stroke and its impact on neurological function.Method:A prospective randomized controlled study was conducted,160 patients with progressive ischemic stroke admitted to the Department of Neurology,the Second Affiliated Hospital of Guangdong Medical University from August 2024 to November 2025 were selected.Patients were divided into the control group(80 cases,treated with Aspirin combined with Clopidogrel Bisulfate)and the study group(80 cases,treated with Tirofiban sequential dual antiplatelet therapy)using a random number table.Both groups received standard basic treatment for ischemic stroke.The overall therapeutic effect,degree of neurological deficit,activities of daily living,levels of inflammatory factors,and platelet function indices were compared between the two groups.Additionally,the incidence of adverse reactions during treatment was recorded.Result:The total effective rate of the study group at 90th days of treatment was 93.75%,which was significantly higher than that of the control group(77.50%)(P<0.05).The NIHSS scores of both groups were significantly reduced at 7th,30th,and 90th days of treatment compared with those before treatment,and the BI scores were significantly higher,the NIHSS scores of the study group were lower than those of the control group,and the BI scores were higher than those of the control group(P<0.05).The levels of inflammatory factors(TNF-α,IL-6,hs-CRP)and platelet activation indicators[platelet α-granule membrane protein 140(GMP-140),thromboxane B2(TXB2)]in the study group were lower than those in the control group at 7th days of treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:For patients with progressive ischemic stroke,sequential application of Tirofiban on the basis of standard dual antiplatelet therapy can more effectively improve neurological deficit and enhance activities of daily living without significantly increasing the risk of adverse reactions.
林军;全洁;龙亚德;李志明;谢荣基
广东医科大学附属第二医院神经内科 广东 湛江 524003广东医科大学附属第二医院神经内科 广东 湛江 524003广东医科大学附属第二医院神经内科 广东 湛江 524003广东医科大学附属第二医院神经内科 广东 湛江 524003广东医科大学附属第二医院神经内科 广东 湛江 524003
医药卫生
替罗非班序贯双联抗血小板治疗进展性缺血性脑卒中神经功能
TirofibanSequential dual antiplatelet therapyProgressive ischemic strokeNeurological function
《中国医学创新》 2026 (21)
16-20,5
湛江市科技计划项目(2022A01126)
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