Abstract:

Objective　To observe the effect of tirofiban on platelet activity in patients with progressive cerebral infarction (PCI) and its clinical application effect. Methods　This was a randomized controlled trial. A total of 106 PCI patients admitted to Affiliated Hospital of Traditional Chinese Medicine, Nanyang Medical College from January 2021 to March 2023 were selected as the study objects, and were divided into a routine group and an experimental group by the random number table method, with 53 cases in each group. In the routine group, 30 males and 23 females, aged (60.11±5.27) years, were treated with conventional medication; in the experimental group, 31 males and 22 females, aged (61.25±5.33) years, were treated with tirofiban on the basis. The improvement of platelet function, inflammatory response, and neurological function before and after treatment were compared between the two groups, and the drug safety was evaluated. t test and χ² test were used. Results　Before treatment, there were no statistically significant differences in the platelet activity, platelet function, inflammatory indexes, and neurological function between the two groups (all P>0.05). After treatment, the levels of β-thromboglobulin (β-TG), granular membrane protein CD62P, CD63, platelet aggregation rate (PAgT), platelet adhesion rate (PAdT), interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP) in the experimental group were all lower than those in the routine group [(15.44±5.16) μg/L vs. (18.25±5.27) μg/L, (55.25±10.47)% vs. (61.45±10.46)%, (10.33±3.41)% vs. (12.28±3.16)%, (35.22±10.17)% vs. (42.11±10.48)%, (28.33±5.14)% vs. (31.45±5.16)%, (60.44±10.28) ng/L vs. (67.62±10.35) ng/L, (10.15±3.22) ng/L vs. (12.37±3.19) ng/L, (7.66±2.11) mg/L vs. (8.82±2.14) mg/L], with statistically significant differences (t=2.774, 3.050, 3.054, 3.435, 3.119, 3.583, 3.566, and 2.810, all P<0.05). After 3, 7, and 14 days of treatment, the National Institutes of Health Stroke Scale (NIHSS) scores of the experimental group were lower than those of the routine group [(30.25±5.14) points vs. (33.47±5.26) points, (24.33±5.18) points vs. (27.85±5.61) points, (20.12±5.41) points vs. (23.36±5.41) points], with statistically significant differences (t=3.188, 3.356, and 3.083, all P<0.05). After treatment, there was no statistically significant difference in the incidence of drug-related adverse reactions between the two groups (P>0.05). Conclusions　Tirofiban can effectively inhibit the platelet activity in patients with PCI, which is of positive significance in improving the platelet function, reducing the inflammatory reaction, and improving the neurological function. Combined use of this drug does not significantly increase the risk of drug-related adverse reactions, with high safety.

Key words:

Tirofiban, Progressive cerebral infarction, Inflammatory response, Platelet activity, Drug safety

摘要：

目的　观察替罗非班对进展性脑梗死（progressive cerebral infarction，PCI）患者血小板活性的影响及临床应用效果。方法　本研究为随机对照试验，前瞻性选取2021年1月至2023年3月南阳医学高等专科学校附属中医院收治的106例PCI患者作为研究对象，采用随机数字表法分为常规组和试验组，每组53例。常规组男30例、女23例，年龄（60.11±5.27）岁，予以常规药物治疗；试验组男31例、女22例，年龄（61.25±5.33）岁，采用替罗非班配合治疗。对比两组患者治疗前后血小板功能、炎症反应及神经功能改善情况，评估两组用药安全性。采用t检验、χ²检验。结果　治疗前，两组患者血小板活性、血小板功能、炎症指标、神经功能比较，差异均无统计学意义（均P>0.05）。治疗后，试验组β-血小板球蛋白（β-TG）、颗粒膜蛋白CD62P、CD63、血小板聚集率（PAgT）、血小板黏附率（PAdT）、白细胞介素-6（IL-6）、IL-8、C-反应蛋白（CRP）均低于常规组［（15.44±5.16）μg/L比（18.25±5.27）μg/L、（55.25±10.47）%比（61.45±10.46）%、（10.33±3.41）%比（12.28±3.16）%、（35.22±10.17）%比（42.11±10.48）%、（28.33±5.14）%比（31.45±5.16）%、（60.44±10.28）ng/L比（67.62±10.35）ng/L、（10.15±3.22）ng/L比（12.37±3.19）ng/L、（7.66±2.11）mg/L比（8.82±2.14）mg/L］，差异均有统计学意义（t=2.774、3.050、3.054、3.435、3.119、3.583、3.566、2.810，均P<0.05）。治疗3 d、7 d、14 d后，试验组美国国立卫生研究院卒中量表（NIHSS）评分均低于常规组［（30.25±5.14）分比（33.47±5.26）分、（24.33±5.18）分比（27.85±5.61）分、（20.12±5.41）分比（23.36±5.41）分］，差异均有统计学意义（t=3.188、3.356、3.083，均P<0.05）。治疗后，两组患者药物相关不良反应发生率比较，差异无统计学意义（P>0.05）。结论　替罗非班能有效抑制PCI患者血小板活性，对改善血小板功能、减轻炎症反应并改善神经功能均有积极意义，联合应用此药未明显增加药物不良反应发生风险，安全性较高。

关键词:

替罗非班, 进展性脑梗死, 炎症反应, 血小板活性, 用药安全性