作者：武宁，李健，贾帅，庞萌，耿建红，王炎强

单位：

261031山东省潍坊市，潍坊医学院附属医院神经内二科 通信作者：王炎强，E-mail：Wangqiangdoctor@126.com

Units：

Second Department of Neurology, Affiliated Hospital of Weifang Medical University, Weifang 261031, China Corresponding author: WANG Yanqiang, E-mail: Wangqiangdoctor@126.com

关键词：

缺血性卒中; 动脉粥样硬化; 依达拉奉右莰醇; 替罗非班; 治疗结果;

Keywords：

Ischemic stroke; Atherosclerosis; Edaravone dexborneol; Terofiban; Treatment outcome

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.295

Funds：

山东省医药卫生科技发展计划项目（ 202003070377 ）；潍坊医学院附属医院 2022 临床研究项目 （2022WYFYLCYJ02）

摘要：

目的 探讨依达拉奉右莰醇联合替罗非班治疗大动脉粥样硬化型进展性缺血性卒中(PIS)的效果。方法 选取2021年1月至2022年3月于潍坊医学院附属医院神经内二科住院治疗的大动脉粥样硬化型PIS患者68例，采用随机数字表法将其分为观察组和对照组，每组34例。对照组在常规治疗基础上加用替罗非班，观察组在对照组基础上加用依达拉奉右莰醇。比较两组临床疗效及不良反应，治疗前、治疗14 d后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Barthel指数(BI)、CRP、Hcy、中性粒细胞计数、淋巴细胞计数、PLT、HDL-C、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和C反应蛋白/高密度脂蛋白胆固醇比值(CHR)。结果 观察组临床疗效优于对照组(P<0.05)。两组治疗过程中无肝肾功能损伤、消化道反应、头晕头痛、出血及皮疹等不良反应发生。治疗14 d后两组NIHSS评分、mRS评分分别低于本组治疗前，BI分别高于本组治疗前，且观察组NIHSS评分、mRS评分低于对照组，BI高于对照组(P<0.05)。治疗14 d后两组CRP、Hcy、PLT、中性粒细胞计数、NLR、PLR、CHR分别低于本组治疗前，HDL-C、淋巴细胞计数分别高于本组治疗前，且观察组CRP、Hcy、PLT、中性粒细胞计数、NLR、PLR、CHR低于对照组，HDL-C、淋巴细胞计数高于对照组(P<0.05)。结论 依达拉奉右莰醇联合替罗非班治疗大动脉粥样硬化型PIS的效果确切，可有效改善患者神经功能，提高患者生活质量，减轻炎症反应，且安全性良好。

Abstract：

【Abstract】 Objective To investigate the effect of edaravone dexborneol combined with tirofiban in the treatment of large atherosclerotic progressive ischemic stroke (PIS) . Methods A total of 68 patients with large atherosclerotic PIS who were hospitalized in the Second Department of Neurology of Affiliated Hospital of Weifang Medical University from January 2021 to March 2022 were selected. They were divided into observation group and control group by random number table method, 34 cases in each group. The control group was given tirofiban on the basis of conventional treatment, and the observation group was given edaravone dexborneol on the basis of the control group. The clinical efficacy and adverse reactions, National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, Barthel Index (BI) , CRP, Hcy, neutrophil count, lymphocyte count, PLT, HDL-C, neutrophil to lymphocyte ratio (NLR) , platelet to lymphocyte ratio (PLR) , C-reactive protein to high density liptein cholesterol ratio (CHR) before treatment and at 14 d after treatment were compared between the two groups. Results The clinical efficacy of the observation group was better than that of the control group (P < 0.05) . There were no adverse reactions such as liver and kidney function damage, digestive tract reactions, dizziness, headache, bleeding and rash in the two groups during the treatment. After 14 days of treatment, the NIHSS score and mRS score of the two groups were lower than those before treatment, and the BI was higher than that before treatment respectively (P < 0.05) . The NIHSS score and mRS score of the observation group were lower than those of the control group, and the BI was higher than that of the control group (P < 0.05) . After 14 days of treatment, CRP, Hcy, PLT, neutrophil count, NLR, PLR and CHR in the two groups were lower than those before treatment, HDL-C and lymphocyte count were higher than those before treatment, respectively, and CRP, Hcy, PLT, neutrophil count, NLR, PLR and CHR in the observation group were lower than those in the control group, HDL-C and lymphocyte count were higher than those in the control group (P < 0.05) . Conclusion Edaravone dexborneol combined with tirofiban is effective in the treatment of large atherosclerotic PIS, which can effectively improve the neurological function of patients, improve the quality of life of patients, reduce inflammatory response, and has good safety.

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