侯琳琳

[摘要] 目的 探討替罗非班用于急性进展性脑梗死患者治疗中的临床疗效及治疗安全性。 方法 选取2019年1—12月在我院接受治疗的急性进展性脑梗死患者88例，依据随机数字表法分为两组，每组各44例。对照组实施常规氯吡格雷+拜阿司匹林治疗的，观察组实施常规用药+替罗非班治疗。比较两组护理干预后患者日常生活能力、神经功能改善情况、对血小板功能影响情况以及治疗期间不良事件发生情况。 结果 观察组治疗7 d、14 d后的NIHSS评分显著低于对照组，差异有统计学意义（P<0.05）;观察组治疗7 d、14 d后的ADL评分显著高于对照组，差异有统计学意义（P<0.05）;观察组治疗7 d后P-selectin、CD62P、PAgT及PAdT显著低于对照组，差异有统计学意义（P<0.05）;两组不良反应总发生率比较，差异无统计学意义（P>0.05）。 结论 将替罗非班应用于急性进展性脑梗死患者治疗中可有效改善患者日常生活能力以及神经功能，对血小板活化有较强的抑制效果，且治疗安全性较高，有较高的临床应用价值。

[关键词] 急性进展性脑梗死;替罗非班;血小板活化;临床效果

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）13-0046-04

Observation on the clinical efficacy and safety of tirofiban in patients with acute progressive cerebral infarction

HOU Linlin

The Third Department of Neurology， the First People′s Hospital of Shenyang City， Shenyang   110041， China

[Abstract] Objective To explore the clinical efficacy and safety of tirofiban in the treatment of patients with acute progressive cerebral infarction. Methods A total of 88 patients with acute progressive cerebral infarction who were treated in our hospital from January to December， 2019. They were grouped according to the random number table method， with 44 patients in each group. The control group was treated with conventional clopidogrel+Bayaspirin， and the observation group was treated with conventional medicine+tirofiban. The patients′ ability of daily living， neurological function improvement， and influence on platelet function after the nursing intervention， and adverse events during treatment were compared. Results The NIHSS score of the observation group after 7 days and half a month of treatment was significantly lower than that of the control group， and the difference was statistically significant（P<0.05）. The ADL score of the observation group after 7 days and half a month of treatment was significantly higher than that of the control group， and the difference was statistically significant（P<0.05）. The values of P-selectin， CD62P，PAgT and PAdT in the observation group were significantly lower than those in the control group after 7 days of treatment， and the difference was statistically significant（P<0.05）. There was no significant difference in the total incidence of adverse reactions（P>0.05）. Conclusion The application of tirofiban in patients with acute progressive cerebral infarction can effectively improve the patients′ ability of daily living and neurological function， has a strong inhibitory effect on platelet activation， and has high treatment safety and high clinical application value.

[Key words] Acute progressive cerebral infarction; Tirofiban; Platelet activation; Clinical effect

目前随着我国经济结构的改变，居民生活习惯及饮食结构的改变，急性脑梗死已成为我国的一个常见病，急性脑梗死起病具有相当的隐蔽性，且起病的时间也常常让人猝不及防，往往在凌晨发病，一旦突然发病且救治若不及时，极容易发生致死及严重致残[1]。在急性脑梗死中，发病后48 h神经功能缺损症状不仅不能緩解，且呈不停的急性加重的情况属于急性进展性脑梗死，属于急性脑梗死中较难治疗，并且治疗效果欠佳的一种类型。如果患者在48 h内能够接受及时且有效的治疗，能够技术开通闭塞的血管，并于48 h内接受有效治疗，在进行有效的开通治疗，并且结合康复科进行积极的康复，预后效果仍有较高保障[2]。……