| Objectives:To investigate the clinical efficacy and safety of tirofiban in the treatment of progressive anterior circulation cerebral infarction,so as to find a therapeutic scheme with good efficacy and high safety for the treatment of progressive anterior circulation cerebral infarction,To improve the prognosis and quality of life of patients.Methods:A total of 204 patients with progressive anterior circulation cerebral infarction diagnosed in Cangzhou People’s Hospital from February 2019 to November 2020[1-4]were collected,204 patients were randomly divided into control group and experimental group,in which 3 cases did not take medicine according to medical advice,15 cases were lost to follow-up,186 cases were left after elimination,87 cases in experimental group and 99 cases in control group.All patients received basic treatment in accordance with The 2018guidelines for the diagnosis and treatment of acute ischemic stroke in China[5],basic treatment includes oxygen inhalation,ECG monitoring,blood pressure control,statins lowering blood lipid and other general treatment,nerve protection,improving collateral circulation,scavenging oxygen free radicals,expanding capacity,reducing fibrinogen and other conventional treatment.Control group was given aspirin（100mg）combined with clopidogrel（75mg）dual antiplatelet therapy,patients in the experimental group were given tirofiban:intravenous infusion at a rate of 0.4μg/kg/min for 30min,and then intravenous pump point was maintained at a rate of 0.1μg/kg/min for 36h,at 32h,patients were given sequential treatment with aspirin and clopidogrel at the same dose as the control group.Two experienced neurologists evaluated the NIHSS（National Institutes of Health Stroke Scale）scores of each patient before,at 3d,14d,30d,and 90d after treatment,MRS（Modified Rankin Scale）scores before and 90 days after treatment.The score results and the general basic information of the patients were recorded,the number and specific circumstances of adverse reactions were recorded,and the number of cases that progressed again after active treatment was recorded.The collected results were statistically analyzed.NIHSS score and MRS score were used to evaluate the efficacy and prognosis,the incidence of adverse reactions was used to evaluate the safety of the drug,and the incidence of recurrent progression was used to evaluate whether tirofiban could reduce the recurrence of progressive cerebral infarction and improve the long-term prognosis.Results:1 Comparison of basic data equilibria between the two groups:There was no statistically significant difference in general data between the two groups（P>0.05）,and the two groups were comparable.2 Efficacy and prognosis of the two groups2.1 Comparison of NIHSS scores between the two groups:2.1.1 Comparison between groups:Before treatment,there was no significant difference in NIHSS scores between the two groups（P>0.05）.Comparison of NIHSS scores in the two groups at different time points after treatment showed that scores in the experimental group were lower than those in the control group,and the differences were statistically significant（P<0.05）.After 3 days of treatment,the difference of NIHSS score decrease between the two groups was higher in the experimental group than in the control group,and the difference was statistically significant（P<0.001）.2.1.2 Comparison within the group:Compared with before treatment,NIHSS scores in 2 groups were decreased at 3d,14d,30d and 90d after treatment,with statistical significance（P<0.05）.Compared with 3 days after treatment,there were statistically significant differences in NIHSS scores between 2 groups at 14,30 and 90 days after treatment（P<0.05）.Compared with 14d after treatment,there were statistically significant differences in NIHSS scores between the two groups at 30d and 90d after treatment（P<0.05）.Compared with 30 days after treatment,there was statistically significant difference in NIHSS rating within groups in the experimental group at 90 days after treatment（P<0.05）,while there was no statistically significant difference in the control group（P>0.05）.2.1.3 The total effective rate of the experimental group was higher than that of the control group,and the difference was statistically significant（P<0.05）.The effective rate of the experimental group was significantly higher than that of the control group（P<0.001）.2.2 Comparison of m RS score between the two groups:2.2.1 Comparison between groups:Before treatment,there was no statistical significance in MRS score between the two groups（P>0.05）.90d after treatment,the MRS score of the experimental group was significantly lower than that of the control group,the difference was significant（P<0.001）.2.2.2 Comparison within the group:compared with before treatment,intra-group comparison of MRS rating of patients in both groups decreased90 days after treatment,with statistical significance（P<0.05）.2.2.3 The rate of good prognosis in the experimental group was significantly higher than that in the control group（P<0.001）.3 Comparison of recurrence progression between the two groups:the incidence of recurrence progression between the experimental group and the control group（3.45%VS 13.13%P<0.05）,the difference was statistically significant.4 Comparison of the incidence of adverse reactions between the two groups:the incidence of adverse reactions in the experimental group VS the incidence of adverse reactions in the control group（3.45%VS 2.02%P>0.05）,the difference was not statistically significant.Conclusions:1 The efficacy of tirofiban combined with dual antiplatelet sequential therapy was significantly better than that of aspirin combined with clopidogrel alone in patients with progressive anterior circulation cerebral infarction,and the neurological function and quality of life of the patients were significantly improved.2 The application of tirofiban in the treatment of progressive cerebral infarction of anterior circulation can reduce the incidence of recurrent exacerbation of progressive cerebral infarction,reduce the deterioration of stroke and improve the prognosis.3 There is no significant difference in safety between tirofiban combined with dual antiplatelet sequential therapy and aspirin combined with clopidogrel alone in patients with progressive anterior circulation cerebral infarction,indicating safety and reliability of medication. |
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