Efficacy of tirofiban combined with mechanical stent thrombectomy in patients with acute ischemic stroke
Objective To explore the effects of tirofiban combined with mechanical stent thrombectomy on vascular recanalization and plasma viscosity in patients with acute ischemic stroke.Methods A total of 106 patients with acute ischemic stroke admitted to Xingyuan Hospital of Yulin from June 2021 to June 2023 were prospectively selected as the study objects,and were divided into a control group and an observation group with 53 patients in each group by the random number table method.In the control group,there were 29 males and 24 females,aged(62.38±7.24)years,and the course of disease was(2.54±0.56)h.In the observation group,there were 27 males and 26 females,aged(62.63±7.36)years,and the course of disease was(2.48±0.49)h.The control group received mechanical stent thrombectomy;the observation group received intravenous infusion of tirofiban for 24 h after mechanical stent thrombectomy.The vascular recanalization after treatment was recorded in both groups.The coagulation function[thrombin time(TT),prothrombin time(PT),thrombomodulin(TM),and thrombin-activatable fibrinolysis inhibitor(TAFI)],hemorheology,cerebral hemodynamics[cerebral vascular resistance(CVR),mean blood flow(Qmean),and mean blood flow velocity(Vmean)],and neurotrophic factors were compared between the two groups before and 2 weeks after treatment.The neurological function and quality of life were evaluated in both groups before and after treatment.Statistical methods were x2 test and t test.Results The rate of total vascular recanalization in the observation group after treatment was higher than that in the control group[92.45％(49/53)vs.66.04％(35/53)],with a statistically significant difference(x2=11.24,P＜0.05).After treatment,the TT,PT,Qmean,and Vmean in the observation group were higher than those in the control group[(17.97±2.61)s vs.(16.29±2.42)s,(14.81±2.30)s vs.(12.76±2.24)s,(8.62±0.95)ml/s vs.(7.74±0.74)ml/s,(19.51±2.84)cm/s vs.(17.08±2.57)cm/s],with statistically significant differences(t=3.44,4.65,5.32,and 4.62,all P＜0.05).After treatment,the TM,TAFI,and CVR in the observation group were lower than those in the control group[(14.13±2.01)μg/L vs.(18.14±2.23)μg/L,(23.16±3.54)mg/L vs.(40.45±5.97)mg/L,(70.53±7.26)kPa·s/m vs.(79.32±8.34)kPa·s/m],with statistically significant differences(t=9.72,18.14,and 5.79,all P＜0.05).After treatment,the hemorheological indexes of the observation group were lower than those of the control group,and the levels of neurotrophic factors were higher than those of the control group,with statistically significant differences(all P＜0.05).The scores of National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)in the observation group after treatment were lower than those in the control group[(5.23±1.01)points vs.(7.10±1.13)points,(1.81±0.35)points vs.(2.29±0.43)points],but the score of Stroke-Specific Quality of Life(SS-QOL)was higher than that in the control group[(163.99±24.26)points vs.(131.52±20.18)points],with statistically significant differences(t=8.98,6.30,and 7.49,all P＜0.05).Conclusion Mechanical stent thrombectomy combined with tirofiban therapy can improve the vascular revascularization rate and reduce the plasma viscosity in patients with acute ischemic stroke.
万方数据
维普
