Preventive Effect Of Tirofiban On The Early Neurological Deterioration In Atherosclerotic Cerebral Infarction

Objective:To explore and evaluate the safety and effectiveness of tirofiban in preventing the deterioration of neurological function in the early stage of atherosclerotic cerebral infarction.Method:We selected 80 patients with ischemic stroke who were classified as having large atherosclerosis(LAA)by TOAST within 24 hours of onset in Jiangxi Provincial People’s Hospital from December 2020 to December 2022.According to the inclusion and exclusion criteria,40 patients with atherosclerotic cerebral infarction were assigned to Tirofiban and 40 patients with conventional oral double antiplatelet drugs.The degree of neurological impairment was assessed by the National Institutes of Health Stroke Scale(NIHSS),The functional prognosis was evaluated by m RS score,and the patients in the two groups were observed for symptomatic intracranial hemorrhage(sICH),intracranial hemorrhage(ICH),thrombocytopenia,and other adverse complications.Result:1.There is no difference in baseline data between the experimental group and the oral double group.NIHSS comparison at each time point: there is no difference in NIHSS scores between the two groups at admission and 24 hours after treatment,P>0.05,indicating no statistical significance;The difference in NIHSS scores between the two groups after treatment for 48 hours and 7 days(P<0.05),indicating statistical significance.2.Comparison of NIHSS scores before and after treatment in the experimental group: after statistical analysis,Wilcoxon test showed that Z=-5.179,Z=-5.429,Z=-4.767,Z=-4.915,Z=-4.388,Z=-3208,P values were all less than 0.05,both of which were statistically significant,suggesting that tirofiban can prevent the deterioration of neurological function in the early stage of atherosclerotic cerebral infarction to a certain extent.3.The comparison of NIHSS scores before and after treatment in the oral double group,after statistical analysis,Wilcoxon test showed that Z=-2.958,Z=-3.24,Z=-2.472,Z=-2.565,Z=-2.941,Z=-3.910,P values were all less than 0.05,both of which were statistically significant,suggesting that the patients with atherosclerotic cerebral infarction should use conventional oral double antiplatelet drugs treatment as soon as possible after onset,which may further improve the neurological deficit symptoms.4.Comparison of m RS between the two groups before treatment and after 90 days of treatment: before intervention,the m RS of the two groups was tested by Mann-Whitney U,P>0.05,indicating no statistical difference;After 90 days of tirofiban treatment,m RS was lower than that of the oral double group(P<0.05),which was statistically significant,indicating that tirofiban may improve the long-term prognosis of atherosclerotic cerebral infarction.5.Comparison of clinical efficacy between the two groups: the total effective rate of tirofiban was 92.5%,and that of the control group was 67.5%.The total effective rate of tirofiban was significantly higher than that of the oral double group.The total effective rate between the two groups was statistically significant(P=0.01).6.Safety comparison: the number of symptomatic intracranial hemorrhage and intracranial hemorrhage in the experimental group and the oral double group was 3,2,3 and 2,respectively.95% confidence interval: 1.541(0.243,9.754),P>0.05,there was no statistical difference between the two groups.Although there were 2 cases of thrombocytopenia and 1 case of thrombocytopenia in the experimental group and the oral double group,there was no statistical significance in the two groups.Conclusion:1.In the early stage of atherosclerotic cerebral infarction,early use of tirofiban or routine oral double antiplatelet drugs can reduce the NIHSS score.2.Tirofiban can more effectively prevent the deterioration of neurological function in the early stage of atherosclerotic cerebral infarction,and improve the long-term prognosis of patients.3.For atherosclerotic cerebral infarction,the incidence of adverse events of tirofiban bridge interface taking conventional oral double antiplatelet drugs was low,and there was no significant statistical difference compared with the oral double group.