文章摘要
张莉 ,傅新民 ,智文虹 ,刘志广.静脉溶栓后序贯替罗非班联合胶体扩容治疗急性缺血性脑卒中的安全性及有效性[J].神经损伤功能重建,2024,(2):77-80
静脉溶栓后序贯替罗非班联合胶体扩容治疗急性缺血性脑卒中的安全性及有效性
Safety and Effectiveness of Tirofiban Treatment Combined with Colloid Expansion afterIntravenous Thrombolysis in Patients with Acute Ischemic Stroke
  
DOI:
中文关键词: 急性缺血性脑卒中  静脉溶栓  替罗非班  胶体扩容
英文关键词: acute ischemic stroke  intravenous thrombolysis  tirofiban  colloid expansion
基金项目:徐 州 市 科 技 项 目 (后循环大血管闭 塞的急性卒中血管 内治疗的安全性和 有 效 性 研 究 ,No. KC21234)
作者单位
张莉1 ,傅新民2 ,智文虹2 ,刘志广2 1. 蚌埠医学院研究 生院 2. 徐 州 市 中 心 医 院 
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中文摘要:
      目的:探讨急性缺血性脑卒中患者静脉溶栓后序贯替罗非班联合胶体扩容治疗的安全性及有效性。 方法:选取2021年1月至2023年6月徐州市中心医院收治的急性缺血性脑卒中患者160例为研究对象,随 机分为实验组和对照组,给予对照组(80例)阿替普酶溶栓治疗,实验组(80例)在对照组基础上序贯替罗非 班联合胶体扩容治疗,疗程为48 h,之后2组均续以抗血小板聚集治疗。观察2组出血、血小板减少等不良 事件发生情况以评价其安全性;采用美国国立卫生院卒中量表(NIHSS)评分评价神经功能缺损程度,改良 Rankin量表(mRS)评分评价神经功能恢复状况。结果:自溶栓至第10天,2组血小板减少的发生率差异无 统计学意义(P>0.05);自溶栓至第3天,2组严重出血及轻微出血发生率差异均无统计学意义(P>0.05)。 溶栓治疗7、14、30 d后,实验组的NIHSS评分低于对照组(P<0.05);治疗14、30 d后,实验组疗效优于对照 组(P<0.05);治疗14、30、90 d后,实验组mRS评分低于对照组(P<0.05)。结论:急性缺血性脑卒中溶栓后 序贯替罗非班联合胶体扩容治疗安全有效,能够改善患者神经功能结局,降低死亡率及致残率。
英文摘要:
      To investigate the safety and efficacy of sequential tirofiban combined with colloid volume expansion therapy after intravenous thrombolysis in patients with acute ischemic stroke. Methods: A total of 160 patients with acute ischemic stroke admitted to Xuzhou Central Hospital from January 2021 to June 2023 were selected as the research subjects and were randomly divided into the experimental group and the control group. Cases in the control group (n=80) were given thrombolytic treatment with alteplase only, and cases in the experimental group (n=80) were treated with sequential tirofiban combined with colloid volume expansion therapy on top of the control group’s treatment for a course of 48 hours. Subsequently, both groups were continued with antiplatelet aggregation therapy. The occurrence of adverse events such as bleeding and thrombocytopenia was observed to evaluate the safety in both groups; the degree of neurological deficit was assessed using the National Institutes of Health Stroke Scale (NIHSS) score, and the recovery of neurological function was evaluated using the modified Rankin Scale (mRS) score. Result: From thrombolysis to day 10, there was no significant difference in the incidence of thrombocytopenia between the two groups (P>0.05). From thrombolysis to day 3, there was no significant difference in the incidence of severe and minor bleeding between the two groups (P>0.05). At 7, 14, and 30 days after thrombolytic therapy, the experimental group had lower NIHSS scores than the control group (P<0.05); at 14 and 30 days after treatment, the experimental group showed better therapeutic effects than the control group (P<0.05); at 14, 30, and 90 days after treatment, the experimental group had lower mRS scores than the control group (P<0.05). Conclusion: Sequential tirofiban combined with colloid volume expansion therapy following thrombolysis in acute ischemic stroke patients is safe and effective, improving neurological outcomes and reducing mortality and disability rates.
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