【摘要】 目的 分析超急性期脑梗死溶栓失败后替罗非班对血清microRNA-181c(miR-181c)、microRNA-130a(miR-130a)表达量影响。方法 选定2022年11月至2024年11月河北北方学院附属第一医院住院的85例超急性期脑梗死溶栓失败患者，根据治疗方案将研究对象分组，对照组42例应用常规治疗，观察组43例在常规疗法的基础上应用替罗非班治疗，统计学比较总有效率、梗死体积、脑灌注参数、血管再通率、美国国立卫生研究院卒中量表（national institutes of health stroke scale,NIHSS）、巴氏指数（bathel-index,BI）评分、凝血功能指标、血清miR-181c、miR-130a以及出血时间发生情况。结果 总有效率以及血管再通率观察组均比对照组高（P<0.05）。观察组治疗后梗死体积、达峰时间（time to peak,TTP）、平均通过时间（mean transit time,MTT）、NIHSS评分、血小板计数（platelet,PLT）、纤维蛋白原（fibrinogen,FIB）、血清miR-181c、miR-130a均比对照组更低（P<0.05），观察组治疗后脑血流量（cerebral blood flow,CBF）、脑血容量（cerebral blood volume,CBV）、BI评分、凝血酶原时间（prothrombin time,PT）较对照组更高（P<0.05）。出血事件总发生率两组对比差异无统计学意义（P > 0.05）。结论 超急性期脑梗死溶栓失败后给予替罗非班进行补救治疗，可有效减轻患者神经功能受损程度，缩小梗死体积，提高血管再通率、生活能力，纠正血液高凝状态，改善脑灌注参数，降低血清miR-181c、miR-130a表达量及出血性不良事件发生率，安全有效。更多还原

【Abstract】 Objective To analyze the effects of tirofiban on serum microRNA-181c( miR-181c) and microRNA-130a(miR-130a) expression in patients with hyperacute cerebral infarction after thrombolytic failure.Methods A total of 85 patients with hyperacute cerebral infarction who failed thrombolysis and were hospitalized at the First Affiliated Hospital of Hebei North University from November 2022 to November 2024 were enrolled. The research subjects were grouped according to the treatment regimen: the control group(n = 42) received conventional treatment,and the observation group(n = 43) received tirofiban treatment in addition to conventional therapy.Statistical comparisons were conducted on the total effective rate,infarct volume,cerebral perfusion parameters,vascular recanalization rate,National Institutes of Health Stroke Scale(NIHSS) score,Barthel Index(BI) score,coagulation function indices, serum miR-181c, miR-130a levels, and occurrences of hemorrhagic events.Results The observation group demonstrated significantly higher total effective rate and vascular recanalization rate compared to the control group(P < 0.05). After treatment,the observation group showed significantly lower infarction volume, time to peak( TTP), mean transit time( MTT), NIHSS score, platelet count( PLT),fibrinogen( FIB), and serum miR-181c and miR-130a levels compared to the control group( P < 0.05). The observation group exhibited significantly higher cerebral blood flow(CBF),cerebral blood volume(CBV),BI score,and prothrombin time(PT) compared to the control group(P < 0.05). There was no significant difference in the overall incidence of hemorrhagic events between the two groups(P > 0.05). Conclusion Rescue treatment with tirofiban after thrombolytic failure in hyperacute cerebral infarction effectively reduces the degree of neurological impairment, decreases infarct volume, improves vascular recanalization rate and functional capacity, corrects hypercoagulability, improves cerebral perfusion parameters, and reduces serum miR-181c and miR-130a expression levels and the incidence of hemorrhagic adverse events,proving to be safe and effective.更多还原