The influence of tirofiban or argatroban treatment on neurological function and adverse reactions in patients with cerebral infarction within the superthrombolysis time window
替罗非班或阿加曲班治疗对超溶栓时间窗脑梗死患者神经功能及不良反应的影响

摘要

目的 对比替罗非班与阿加曲班单药治疗超溶栓时间窗（9~72 h）急性缺血性脑梗死（AIS）患者的疗效及安全性。方法 选取2023年3月至2024年3月本院收治的超溶栓时间窗AIS患者60例，采用随机数字表法分为两组，均给予基础治疗，观察组加用替罗非班抗血小板，对照组加用阿加曲班抗凝。比较两组神经功能、日常生活能力、药物起效及最佳预后时间，分析不良反应发生情况。结果 观察组药物起效时间短于对照组，NIHSS、ADL评分改善幅度优于对照组（P<0.05）；两组mRS预后良好率、出血不良反应发生率无显著差异（P>0.05）。结论 替罗非班单药治疗超溶栓时间窗脑梗死的神经功能改善速度更快，阿加曲班单药安全性表现平稳，临床可根据血栓风险、出血倾向个性化选择用药。

Abstract

Objective To compare the efficacy and safety of tirofiban and argatroban as monotherapy in patients with acute ischemic cerebral infarction (AIS) within the superthrombolysis time window (9-72 hours).
Methods Sixty patients with superthrombolysis time window AIS admitted to our hospital from March 2023 to March 2024 were selected and divided into two groups by random number table method. Both groups were given basic treatment. The observation group was added with tirofiban antiplatelet, and the control group was added with argatroban anticoagulation. The neurological functions, activities of daily living, drug onset and the best prognosis time of the two groups were compared, and the occurrence of adverse reactions was analyzed.
Results The onset time of the drug in the observation group was shorter than that in the control group, and the improvement amplitudes of NIHSS and ADL scores were better than those in the control group (P<0.05). There was no significant difference in the good prognosis rate and the incidence of bleeding adverse reactions between the two groups of mRS (P>0.05).
Conclusion   Tirofiban monotherapy shows a faster improvement in neurological function for cerebral infarction within the superthrombolysis time window. Argatroban monotherapy has a stable safety performance. Clinically, medication can be selected based on the risk of thrombosis and bleeding tendency.