Ben-Yang Chen, Yu-Zhang Bei, Jian-Huang Chen, Wei-Li Bai
{"title":"机械取栓联合替罗非班治疗急性颅内动脉粥样硬化性脑梗死的临床观察及对血清炎症因子的影响","authors":"Ben-Yang Chen, Yu-Zhang Bei, Jian-Huang Chen, Wei-Li Bai","doi":"10.62347/FJGC1286","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 7","pages":"5689-5697"},"PeriodicalIF":1.6000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351620/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mechanical thrombectomy combined with tirofiban for treatment of acute intracranial atherosclerotic cerebral infarction: clinical observations and effect on serum inflammatory factors.\",\"authors\":\"Ben-Yang Chen, Yu-Zhang Bei, Jian-Huang Chen, Wei-Li Bai\",\"doi\":\"10.62347/FJGC1286\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":7731,\"journal\":{\"name\":\"American journal of translational research\",\"volume\":\"17 7\",\"pages\":\"5689-5697\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351620/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of translational research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.62347/FJGC1286\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of translational research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/FJGC1286","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:评价机械取栓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对炎症因子水平的影响。方法:回顾性研究了2022年12月至2024年12月湖南省浏阳市集利医院收治的102例急性颅内大动脉粥样硬化性脑梗死患者。将患者分为对照组(MT)和观察组(MT +替罗非班)。治疗前后评估包括血运重成率、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)、活化部分凝血活素时间(APTT)、神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)、髓鞘碱性蛋白(MBP)。采用美国国立卫生研究院卒中量表(NIHSS)、简易精神状态检查(MMSE)、改良Barthel指数(MBI)和Fugl-Meyer评估(FMA)评估神经功能。Logistic分析确定影响血管再通的因素。结果:治疗后观察组血运重建率较高(94.12% vs 78.43%)。结论:替罗非班联合MT可改善急性颅内大动脉粥样硬化性脑梗死患者血运重建率,减轻炎症及神经生化损伤,增强神经功能,降低再闭塞风险。
Mechanical thrombectomy combined with tirofiban for treatment of acute intracranial atherosclerotic cerebral infarction: clinical observations and effect on serum inflammatory factors.
Objective: 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.
Methods: 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.
Results: 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).
Conclusion: 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.