Preventive effect of intravenous thrombolysis with alteplase combined with tirofiban in the progression of acute cerebral infarction and related factors
Objective To analyze the preventive effect of sequential intravenous thrombolysis with al-teplase combined with tirofiban on the progression of acute cerebral infarction and related factors.Methods A total of 72 patients with cerebral infarction from Lishui People's Hospital from July 2019 to July 2022 were ran-domly divided into a control group and a observation group,with 36 cases in each group.The control group re-ceived intravenous thrombolytic intervention with alteplase,and the observation group added tirofiban on this ba-sis.The clinical efficacy,NIHSS score of the two groups were compared.According to the curative effect of the pa-tients in the observation group,they were divided into two groups:the obvious group and the other group.The clinical data of the patients in the two groups were compared,and the factors affecting the curative effect of the se-quential intravenous thrombolysis of ateplase combined with tirofiban in the treatment of acute progressive cerebral infarction were analyzed by binary logistic regression.Results A total of 16 patients in the observation group and 25 patients in the control group had progressive cerebral infarction after treatment,and the conversion rate in the control group was significantly higher(x2=4.589,P=0.032).After treatment,coagulation indexes increased and NIHSS scores decreased in both groups[(14.4±0.6)s vs(13.0±0.8)s,(32.6±1.8)s vs(30.4±1.1)s,(19.4±1.1)s vs(18.0±1.2)s].The PT,APTT and TT were higher in the observation group then in the control group after treatment[(6.1±1.3)score vs(8.9±1.6)]score,(t=8.384,6.234,5.408,-7.921,P＜0.05).In the observation group,the inci-dence of diabetes,hypertension,hyperlipidemia,platelet abnormality and fibrinogen abnormality were less in the unconverted patients,and the NIHSS score was lower on admission(11±3 vs 14±3)(P＜0.05).Logistic regression analysis showed that diabetes,hypertension,hyperlipidemia,platelet,fibrinogen and NIHSS score at admission were the factors affecting the transformation of progressive cerebral infarction(P＜0.05).Evaluation model Y=-1.897×diabetes-1.609×hypertension-1.986×hyperlipidemia+2.833×platelets+1.897×fibrinogen-0.261× NIHSS score at admission+3.530.The area under ROC curve evaluated by the model was 0.925,the specificity was 0.812,the sensitivity was 0.950,the Jorden index was 0.762,and the cut-off value was 0.491.Conclusion The sequential combination of ateplase intravenous thrombolysis and tirofiban has a certain effect on preventing the progression of acute cerebral infarction,which can improve neurological and coagulation functions in patients with acute cerebral infarction;Diabetes,hypertension,hyperlipidemia,platelets,fibrinogen,NIHSS score at admis-sion are the main factors affecting the prevention effect.
万方数据
维普
