Factors affecting reocclusion and the effect of tirofiban therapy in patients with cerebral infarction treated by intravenous thrombolysis with alteplase
阿替普酶静脉溶栓治疗脑梗死患者的再闭塞影响因素及替罗非班治疗效果

摘要

目的 探究阿替普酶静脉溶栓治疗脑梗死患者的再闭塞影响因素及替罗非班治疗效果。方法 择取本院2023年2月-2024年5月间收治的100例脑梗死患者，以阿替普酶静脉溶栓治疗脑梗死是否再闭塞分组，闭塞入对照组，未闭塞入观察组，各入组50例。观察组给予替罗非班治疗。结合Logistic回归模型分析脑梗死患者阿替普酶静脉溶栓治疗再闭塞影响因素。对比两组治疗前与治疗后不同时期：重组人组织型纤溶酶原激酶衍生物（rPA）；纤溶酶原激活物抑制剂（PAI-1）的值。评估治疗前后不同时期患者卒中量表NIHSS、简易精神状态量表MMSE评分。结果 两组基线资料对比无明显差异，与闭塞无关联意义。2型糖尿病、血糖、收缩压、NIHSS评分、起病-溶栓时间具有统计学意义。治疗前rPA、PAI-1值为25.23±1.57、48.56±5.23；治疗后检测rPA的值持续升高、PAI-1值持续降低。治疗前NIHSS、MMSE评分为15.23±2.61、12.45±1.85；治疗后患者NIHSS评分持续降低、MMSE评分持续升高，（P<0.05）。结论 阿替普酶静脉溶栓治疗脑梗死患者的再闭塞影响因素有2型糖尿病、血糖、收缩压、NIHSS评分、起病-溶栓时间。再闭塞以替罗非班治疗，可改善神经功能，提高治疗效果。

Abstract

Objective: To explore the influencing factors of reocclusion and the effect of alteplase intravenous thrombolysis in the treatment of cerebral infarction patients.
Methods: 100 patients with cerebral infarction admitted to our hospital from May 2023 to May 2024 were selected to group for cerebral infarction with alteplase intravenous thrombolysis. The occlusion was included in the control group, and 50 cases were included in each group. The observation group was given tirofiban treatment. Analysis of the factors of re-occlusion with alteplase intravenous thrombolytic therapy in patients with cerebral infarction in combination with Logistic regression model. Values of the recombinant human tissue plasminogen kinase derivative (rPA); plasminogen activator inhibitor (PAI-1). NIHSS and Simple Mental State Scale MMSE scores at different periods before and after treatment.
Results: There was no significant difference between the two groups, and there was no association with occlusion. Type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, onset-thrombolysis time were statistically significant. The rPA and PAI-1 values were 25.23 ± 1.57 and 48.56 ± 5.23; the values of rPA and PAI-1 decreased continuously after treatment. The NIHSS and MMSE scores were 15.23 ± 2.61 and 12.45 ± 1.85; the NIHSS scores and MMSE scores increased continuously (P <0.05).
Conclusion  : Type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, and onset-thrombolysis time were considered. Re-occlusion and treatment with tirofiban can improve the neurological function and improve the therapeutic effect.