| Objectives Through observing the effects of tirofiban injection on the maximum aggregation rate(MAR),inflammatory cytokine index(hs-CRP),and interleukin 6(IL-6)in patients with stroke in progression(SIP),the clinical effect of tirofiban injection on SIP was investigated.Methods From May 2017 to December 2018,100 patients who met the inclusion criteria in the second department of neurology and the fourth department of neurology in the affiliated hospital of north China university of science and technology were selected as the research objects.This experiment was approved by the ethics committee of our hospital.The patients were divided into treatment group and control group by random number table,50cases each.After admission,patients in both groups were treated according to the 2018guidelines for the diagnosis and treatment of acute ischemic stroke in China,including anti-platelet therapy,oxygen intake,monitoring of vital signs,stabilizing plaques,controlling cerebral edema,improving circulation,and controlling patients’blood pressure,blood glucose and lipid.After the disease progression,the control group continued to receive antiplatelet therapy with aspirin(100mg/day).The treatment group was treated with tirofiban injection on the basis of the control group.Usage:12.5mg of tirofiban was dissolved in 0.9%sodium chloride injection 250ml,that is,sodium chloride injection of tirofiban hydrochloride with a concentration of 50ug/ml.Continuous intravenous infusion was conducted at 6ml/h for a total of 41.6h.Both groups were treated for a total of 14 days.Compare the two groups of patients during hospitalization progress,2 days after treatment,treatment after 14 days of the United States national institutes of health stroke scale(NIHSS score),at the same time monitoring MAR,inflammatory factor index(hs-CRP,IL-6),compare the progress,90days after treatment by modified Rankin scale(mRS score)and ADL improved Barthel index rating scale index(BI)of two groups of patients daily life ability to assess and observe adverse reactions during the treatment of bleeding,etc.,and for class injection group had stroke curative effect comparison of different pathological classification,To observe the effective rate and further understand the efficacy of tirofiban injection in progressive stroke.Results 1 At the time of progression,there was no significant difference in NIHS S scores between the control group and the treatment group(P>0.05).Two days after treatment and 14 days after treatment,the NIHSS scores of the two groups were(10.50±2.39 VS 9.30±2.05,P=0.008)and(8.52±4.11 VS 5.86±3.25,P=0.001)respectively.2 At the time of progression,mRS score and BI index of patients in the control group and the treatment group were comparable,P>0.05,and the diff erence was statistically significant.At 90 days after treatment,the mRS score and BI index of the two groups were(2.60±1.11 VS 2.06±1.11,P=0.017),(67.42±8.08 VS 78.28±6.90,P=0.000),and the difference was statistically significant(P<0.05).3 The effective rate of the control group and the treatment group was 82%vs58%,the difference was statistically significant(c~2=6.857,P<0.05).4 At the time of progression,MAR of AA pathway and ADP pathway in the control group and t he treatment group were(55.86±8.01%VS 57.71±7.97%,P=0.250)and(76.81±9.41%VS 77.66±9.61%,P=0.658),respectively,showing no significant difference(P>0.05).MAR of AA pathway in the control group and the treatment group was(40.92+5.71%VS 30.34±5.26%,P=0.000),showing statistical significance.After 14days of treatment,there was no significant difference in MAR(46.02+12.86%VS46.61±11.87%,P=0.812)between the control group and the treatment group.MAR of ADP pathway was 57.14±10.34%VS 49.34±7.82%,P=0.000,and 61.71±12.58%VS 61.08±10.55%,P=0.789,respectively.The MAR of AA and ADP pathway in the two groups was statistically significant 2 days after treatment,and no signif icant difference was found 14 days after treatment.5 At the time of progression,th ere was no significant difference in hs-crp and il-6 between the control group and t he treatment group(P>0.05).Two and 14 days after treatment,the serum hs-crp and il-6 of the two groups were(3.51±1.23 VS 2.96±1.00,P=0.706),(111.93±19.29 VS 95.46±18.57,P=0.000),(2.96±0.50 VS 2.08±0.90),respectively.P=0.000),(95.49±14.66 VS 72.45±12.88,P=0.000).The difference was statistically significant(P<0.05).6 Adverse bleeding events:at the time of progression,partial thrombin time(APTT)and platelet count(PLT)of patients in the treatment group and the contro l group were comparable without statistical significance,and there was no significan t change 14 days after treatment compared with that before,and there was no stati stical significance between the two groups.The total number of patients with follo w-up bleeding adverse events in the treatment group was more than that in the con trol group,but none of them reached the standard to be excluded.7 The effective rate of tirofiban injection in the treatment of small-artery occlusive stroke was 95.45%,which was better than that of atherosclerotic stroke,unexplained stroke and oth er clearly caused stroke,P=0.027,indicating a difference.Conclusions 1 Tirofiban injection can alleviate the nerve function defect in patients with progressive ischemic stroke,improve the prognosis of 90 days,with good efficacy,no bleeding and other adverse reactions,2 The efficacy of tirofiban injection in the treatment of small artery occlusive stroke is better than that of large artery atherosclerosis,other causes and unknown causes,3 Tirofiban injection can reduce the maximum platelet aggregation rate,il-6 and hs-crp levels in patients with progressive ischemic stroke.Figure 0;Table 10;Reference 104... |
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