目的 分析曲克蘆丁聯(lián)合替羅非班治療急性進(jìn)展性腦梗死的臨床療效。方法 選取2020年1月—2023年8月巴彥淖爾市醫(yī)院收治的126例急性進(jìn)展性腦梗死患者，按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各63例。對(duì)照組靜脈滴注鹽酸替羅非班氯化鈉注射液，開始以0.4 μg/(kg∙min)滴注30 min，后以0.1 μg/(kg∙min)維持72 h，之后繼續(xù)常規(guī)治療。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注曲克蘆丁注射液，每次將0.3 g溶于5%葡萄糖注射液250 mL，1次/d。兩組療程均為2周。觀察兩組臨床療效，比較治療前后兩組患者相關(guān)量表[功能綜合評(píng)定量表（FCA）、改良Barthel指數(shù)（MBI）等]評(píng)分、血小板參數(shù)[平均血小板體積（MPV）、血小板聚集率（PAgT）]及凝血指標(biāo)[纖維蛋白原降解產(chǎn)物（FDP）、D-二聚體（D-D）]變化。結(jié)果 治療后，治療組總有效率93.65%，顯著高于對(duì)照組的80.95%（P＜0.05）。治療后，兩組患者NIHSS評(píng)分顯著降低，而FCA、MBI評(píng)分顯著升高（P＜0.05）；治療后，治療組患者NIHSS、FCA、MBI評(píng)分改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組PLT均較同組治療前顯著升高，而MPV、PAgT均顯著下降（P＜0.05）；治療后，治療組血小板參數(shù)改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組PT顯著延長，而FDP、D-D均顯著降低（P＜0.05）；治療后，治療組凝血指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 急性進(jìn)展性腦梗死采用曲克蘆丁聯(lián)合替羅非班治療安全性較佳，能有效提高救治效果，減輕神經(jīng)功能損害，加速患者功能狀態(tài)恢復(fù)，且在進(jìn)一步調(diào)節(jié)機(jī)體凝血功能和抑制血栓形成方面具有優(yōu)勢(shì)。

Objective To analyze the clinical efficacy of troxerutin combined with tirofiban in treatment of acute progressive cerebral infarction. Methods A total of 126 patients with acute progressive cerebral infarction admitted to Bayannur Hospital from January 2020 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the infusion was started at 0.4 μg/(kg∙min) for 30 min, then maintained at 0.1 μg/(kg∙min) for 72 h, after which routine therapy was continued. Patients in treatment group were iv administered with Troxerutin Injection on the basis of the control group, 0.3 g was dissolved in 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, theclinical efficacy was evaluated, changes of scores on relevant scales [functional comprehensive assessment (FCA), modified barthel index (MBI)], platelet parameters [mean platelet volume (MPV), platelet aggregation rate (PAgT)], and coagulation indicators [fibrinogen degradation products (FDP), D-dimer (D-D)] in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 93.65%, which was significantly higher than that of the control group (80.95%, P < 0.05). After treatment, NIHSS scores were significantly decreased, but FCA and MBI scores were significantly increased in both groups (P < 0.05). After treatment, NIHSS, FCA and MBI scores in the treatment group were better than those in the control group (P < 0.05). After treatment, PLT in two groups was significantly higher than before treatment, while MPV and PAgT were significantly decreased (P < 0.05). After treatment, the improvement of platelet parameters in the treatment group was better than that in the control group (P < 0.05). After treatment, PT was significantly prolonged, while FDP and D-D were significantly decreased in both groups (P < 0.05). After treatment, the improvement of coagulation index in treatment group was better than that in control group (P < 0.05). Conclusion The combination of troxerutin and tirofiban is safer for the treatment of acute progressive cerebral infarction, which can effectively improve the treatment effect, reduce neurological damage, accelerate the recovery of patients’ functional status, and have advantages in further regulating the body’s coagulation function and inhibiting thrombosis formation.

R971

巴彥淖爾市科技計(jì)劃項(xiàng)目（K202028）