Chen Ben-Yang, Bei Yu-Zhang, Chen Jian-Huang, Bai Wei-Li
Department of Neurology, Jili Hospital Liuyang 430100, Hunan, China.
Am J Transl Res. 2025 Jul 25;17(7):5689-5697. doi: 10.62347/FJGC1286. eCollection 2025.
To evaluate the clinical efficacy of mechanical thrombectomy (MT) combined with tirofiban in treating acute intracranial large artery atheromatous cerebral infarction and its effect on inflammatory factor levels.
This retrospective study included 102 patients with acute intracranial large atherosclerotic cerebral infarction admitted to Jili Hospital, Liuyang City, Hunan Province, between December 2022 and December 2024. Patients were divided into a control group (MT) and an observation group (MT + tirofiban). Pre-treatment and post-treatment assessments included revascularization rate, hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), D-dimer (D-D), prothrombin time (PT), activated partial thromboplastin time (APTT), neuron-specific enolase (NSE), central neural specific protein (S100β), and myelin basic protein (MBP). Neurological function was evaluated using the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), modified Barthel index (MBI), and Fugl-Meyer assessment (FMA). Logistic analysis was used to identify factors influencing vascular re-canalization.
After treatment, the revascularization rate was higher in the observation group (94.12% vs. 78.43%, P<0.05). NIHSS, D-D, hs-CRP, TNF-α, IL-6, NSE, S100β, and MBP levels decreased significantly, with lower values observed in the observation group (P<0.05). MMSE, MBI, and FMA scores increased more in the observation group (P<0.05). PT and APTT were prolonged significantly, with higher values in the observation group (P<0.05). Logistic regression identified post-treatment NIHSS score as an independent risk factor for re-occlusion (P<0.05).
Tirofiban combined with MT improves revascularization in patients, reduces inflammation and neurobiochemical damage, enhances neurological function, and lowers the risk of re-occlusion in patients with acute intracranial large artery atheromatous cerebral infarction.
评估机械取栓术（MT）联合替罗非班治疗急性颅内大动脉粥样硬化性脑梗死的临床疗效及其对炎症因子水平的影响。
本回顾性研究纳入了2022年12月至2024年12月期间在湖南省浏阳市集里医院收治的102例急性颅内大动脉粥样硬化性脑梗死患者。患者分为对照组（MT）和观察组（MT + 替罗非班）。治疗前和治疗后的评估包括血管再通率、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、D-二聚体（D-D）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、神经元特异性烯醇化酶（NSE）、中枢神经特异性蛋白（S100β）和髓鞘碱性蛋白（MBP）。使用美国国立卫生研究院卒中量表（NIHSS）评价神经功能，使用简易精神状态检查表（MMSE）、改良Barthel指数（MBI）和Fugl-Meyer评估法（FMA）进行评估。采用Logistic分析确定影响血管再通的因素。
治疗后，观察组的血管再通率更高（94.12% 对78.43%，P<0.05）。NIHSS、D-D、hs-CRP、TNF-α、IL-6、NSE、S100β和MBP水平显著降低，观察组的值更低（P<0.05）。观察组的MMSE、MBI和FMA评分升高幅度更大（P<0.05）。PT和APTT显著延长，观察组的值更高（P<0.05）。Logistic回归分析确定治疗后的NIHSS评分是再闭塞的独立危险因素（P<0.05）。
替罗非班联合MT可改善患者的血管再通，减轻炎症和神经生化损伤，增强神经功能，并降低急性颅内大动脉粥样硬化性脑梗死患者的再闭塞风险。
