Objective To analyze the efficacy of tirofiban and dual antiplatelet therapy in patients with acute progressive cerebral infarc-tion(APCI)with hyperthrombolytic time window.Methods A prospective selection of 70 APCI patients admitted to the Department of Neurolo-gy,the Fifth people's Hospital of Datong City from December 2021 to December 2022 with a time window of thrombolysis was conducted.Patients were divided into the conventional group and the combination group according to the random numble table method,with 35 cases in each group.Both groups received conventional treatment.The conventional group received aspirin+clopidogrel dual antiplatelet therapy in addition to conven-tional treatment,while the combination group received tirofiban+dual antiplatelet therapy in addition to conventional treatment.The clinical effi-cacy of the two groups were compared.And the neurological function[assessed using the National Institutes of Health Stroke Scale(NIHSS)score],daily living ability[assessed using the ability daily living scale(ADL)],inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]levels,and incidence of adverse reactions during treatment between two groups were compared.Results There was no statistically significant difference in the total effective rate between the combined group and the conventional group(91.42％vs.85.71％)(P＞0.05).After 14 days of treatment,the NIHSS scores of the two groups were lower than those before treatment,while the ADL scores were higher than those before treatment,the NIHSS score of the combination group was(4.52±1.67)points,which was lower than that of the conventional group(6.28±1.78)points,and the ADL score was(84.23±6.58)points,which was higher than that of the conventional group[(74.34±7.12)points],the difference were statistically significant(P＜0.05).After 14 days of treatment,the levels of hs CRP and IL-6 in two groups were lower than those before treatment,the levels of hs-CRP and IL-6 in the combination group were(11.03±3.68)mg/L and(60.73±13.42)ng/mL,respectively,which were lower than those in the conventional group[(13.55±4.12)mg/L and(78.48±14.57)ng/mL],and the differences were statistically significant(P＜0.05).During the treatment process,there was no statistically significant difference in the incidence of adverse reactions between the combination group and the conventional group(8.57％vs.11.43％)(P＞0.05).Conclusion For patients with acute progressive cerebral infarction with hyperthrombolytic time window,combined treatment with tirofiban on the basis of dual anti-platelet therapy can achieve better therapeutic effect,which can better improve the nerve function,daily living ability and reduce inflammation.
关键词
脑梗死/替罗非班/双联抗血小板/神经功能/日常生活能力/炎症反应
Key words
Brain infarction/Tirofiban/Dual antiplatelet/Nerve function/Ability of daily living/Inflammatory response
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