替罗非班桥接阿司匹林联合氯吡格雷治疗急性脑梗死的有效性和经济性研究

打开文本图片集

中图分类号：R743.3；R956 文献标志码：A

Efficacy and cost-effectiveness of tirofiban bridging therapy followed by aspirin combined with clopidogrel in acute cerebral infarction

YANG Wei，HE Qiaoqiao，HUANG Haihua，FAN Xiuzhen’，LU Dong （1. Clinical Pharmacy Center，The First Afiliated Hospital of Shaoyang University，Shaoyang 422Ooo，China; 2. Department of Nursing，The First Afiliated Hospital of Shaoyang University，Shaoyang 422Oo，China）

Abstract： Objective To evaluate the efficacy and cost-effectiveness of tirofiban bridging therapy followed byaspirincombined with clopidogrel inpatientswithatherosclerosis（AS）-induced cerebral infarction. Methods A retrospective cohort analysis was conducted on 1OO patients with AS induced cerebral infarction admitted to the Departmentof Neurology，TheFirstAffliated Hospital of Shaoyang University，fromAugust 2020 to September 2O21. Based on diffrent treatment strategies，patients were divided into two groups：the intervention group（study group）and the conventional treatment group （control group），each comprising 50 cases.The control group receivedaspirincombined with clopidogrel，while the study group initiall received intravenous tirofiban at a loading dose of 0.4μg/（kg⋅min） followed by a maintenance dose of 0.1μg/（kg⋅ min）for 48 hours，then transitioned to aspirin combined with clopidogrel. Clinical eficacy was assessed in both groups，and the incidence of adverse events was compared.National Institutes of Health stroke scale （NIHSS） scoreswere evaluated before and after treatment，and a cost effectiveness analysis was performed.Results No statistically significant diferences were observed between the study group（tirofiban bridging therapy）and the control group （dual antiplatelet therapy）regarding overall response rate and incidence of adverse events （ P> 0.05）.NIHSS scores decreased significantly in both groups after treatment （ P <0.05），with a more pronounced reduction in the study group （ P<0.05 ）.However，total treatment costs were significantly higher in the study group （ P <0.05）.Sensitivity analysis confirmed that total costs remained significantly elevated in the study group （ P<0.05 ）.Conclusion Both tirofiban bridging therapy and dual antiplatelet therapy alone can reduce the severity of neurological deficits，but tirofiban bridging therapy may involve higher medical costs.

Key words：tirofiban；aspirin；clopidogrel； cerebral infarction；efficacy；cost-effectiveness

动脉粥样硬化（atherosclerosis，AS）被认为是一种慢性炎症性疾病，AS所致的脑梗死则是指脑动脉粥样硬化斑块破裂，继发血小板聚集形成血栓，致使脑供血突然中断，进而导致脑组织缺血缺氧性坏死，并引发一系列神经功能缺损。（剩余7251字）