Application Effect of Tirofiban in Mechanical Thrombectomy for Acute Anterior Circulation Macrovascular Occlusion and Influencing Factors of Prognosis
Objective To investigate the clinical effects of tirofiban used in mechanical thrombectomy for patients with acute anterior circulation macrovascular occlusion,and to analyze the independent factors affecting patients′ prognosis.Methods A total of 160 patients with acute anterior circulation macrovascular occlusion who underwent mechanical thrombectomy in the hospital from February 2019 to February 2023 were selected and divided into the observation group(90 cases)and the control group(70 cases)based on different treatment regimens.The patients in the two groups all underwent mechanical thrombectomy,and received dual antiplatelet aggregation(oral Aspirin Enteric-Coated Tablets and Clopidogrel Bisulfate Tablets)therapy after surgery,on this basis,the patients in the observation group received intravenous pumping of Tirofiban Hydrochloride Concentrated Solution for Injection during surgery and maintenance treatment for 24 h.Both groups had a treatment course of three months.The univariate analysis was used to screen the indicators affecting the prognosis of patients in the observation group,the multivariate Logistic linear regression model was established,the receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of the model,and the Hosmer-Lemeshow test was used to determine the fitting goodness of the model.Results After one and three months of treatment,the National Institute of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)scores in the two groups significantly decreased;the interleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP)levels significantly decreased;the central nervous system specific protein(S100β)and myelin basic protein(MBP)levels significantly decreased;the prothrombin time(PT)and activated partial thromboplastin time(APTT)significantly prolonged(P<0.05).After three months of treatment,the above indicators in the two groups were significantly better than those after one month of treatment,and those in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative bleeding and adverse reactions between the two groups(P>0.05).Preoperative NIHSS score,PT,APTT,hs-CRP and S100β were the independent factors affecting patients′ prognosis(P<0.05).The area under the ROC curve(AUC)was 0.894,the sensitivity was 83.3%,and the specificity was 73.3%.The Hosmer-Lemeshow test showed a good predictive performance of the model(χ²=8.616,P=0.376).Conclusion Tirofiban combined with mechanical thrombectomy can relieve the inflammatory reactions and improve neurological function in patients with acute anterior circulation macrovascular occlusion.PT,APTT,preoperative NIHSS score,hs-CRP and S100β are the independent factors affecting patients′prognosis after surgery.
acute anterior circulation macrovascular occlusiontirofibanmechanical thrombectomyinflammatory reactioncoagulation functionprognosisinfluencing factorpredictive model
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