替罗非班联合丁苯酞治疗超时间窗急性脑梗死患者对血清HO-1、NO、VEGF、Ang-1的影响

摘要 目的：探讨替罗非班联合丁苯酞治疗超时间窗急性脑梗死患者对血清血红素加氧酶-1（HO-1）、一氧化氮（NO）、血管生成素-1（Ang-1）、血管内皮生长因子（VEGF）的影响。方法：选择2018年1月到2020年1月在我院接受治疗的141例超时间窗急性脑梗死患者，采用随机数表法分为联合组（n=71）和单药组（n=70）。单药组给予丁苯酞治疗，联合组在单药组的基础上给予替罗非班治疗。比较两组临床疗效、HO-1、NO、VEGF、Ang-1、美国国立卫生研究院卒中量表（NIHSS）、Barthel指数（Barthel）、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原（FIB）水平变化情况及药物并发症发生情况。结果：治疗后，两组总有效率比较差异显著（P<0.05）；治疗前，联合组和单药组血清HO-1、NO、VEGF、Ang-1比较无显著差异；治疗后联合组和单药组血清HO-1、NO、VEGF随着时间的推移而降低，且联合组均低于单药组，Ang-1随着时间的推移而升高，且联合组均高于单药组，差异显著（P<0.05）；治疗前，联合组和单药组NIHSS、Barthel比较无显著差异；治疗后联合组和单药组NIHSS随着时间的推移而降低，且联合组均低于单药组，Barthel随着时间的推移而升高，且联合组均高于单药组，差异显著（P<0.05）。结论：在超时间窗急性脑梗死患者中应用替罗非班联合丁苯酞效果显著，可能与其可有效改善血清HO-1、NO、VEGF、Ang-1水平有关，且不增加不良反应。

Effect of Tirofiban Combined with Butylphthalide on Serum HO-1, NO, VEGF and ANG-1 in Patients with Acute Cerebral Infarction Beyond Time Window

ABSTRACT Objective: To study Effect of tirofiban combined with butylphthalide on serum Heme oxygenase-1 (HO-1), nitric oxide (NO), angiogenin-1 (ANG-1), vascular endothelial growth factor (VEGF) in patients with acute cerebral infarction beyond time window. Methods: 141 patients with acute cerebral infarction beyond the time window treated in our hospital from January 2018 to January 2020 were selected and divided into combination group (n=71) and single drug group (n=70) by random number table method. The mono-drug group was given butylphthalide treatment, and the combination group was given tirofiban treatment on the basis of mono-drug group. Clinical efficacy, HO-1, NO, VEGF, ANG-1, the National Institutes of Health Stroke Scale (NIHSS), Barthel index (Barthel), thrombin time (TT), prothrombin time (PT), fibrinogen (FIB) levels and the incidence of drug complications were compared between the two groups. Results: After treatment, the total effective rate of the two groups was significantly different (P<0.05); before treatment, there was no significant difference in serum HO-1, no, VEGF, Ang-1 between the combined group and the single drug group; after treatment, the serum HO-1, no, VEGF in the combined group and the single drug group decreased with time, and the combined group was lower than the single drug group, and Ang-1 increased with time, and the combined group was higher than the single drug group, the difference was significant Before treatment, there was no significant difference in NIHSS and Barthel between the combined group and the single drug group; after treatment, NIHSS in the combined group and the single drug group decreased with the passage of time, and Barthel in the combined group increased with the passage of time, and the combined group was higher than the single drug group, the difference was significant (P<0.05). Conclusion: The effect of tirofiban combined with butylphthalide in patients with acute cerebral infarction over time window is significant, which may be related to the effective improvement of serum HO-1, no, VEGF, Ang-1 levels, and does not increase adverse reactions.