阿加曲班治疗急性期脑梗死52例临床疗效分析  

Clinical analysis of therapeutic effect of argatroban for acute cerebral infarction: a report of 52 cases

作　　者：李和侠[1] 刘惠娟[1] 尹伟[1] 许力[2] 张军莉[1] LI He-xia;LIU Hui-juan;YIN Wei(Department of Neurology, the Second Peopled Hospital of Bengbuy Bengbu, Anhui 233000, China)

机构地区：[1]蚌埠市第二人民医院神经内科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院神经内科,安徽蚌埠233004

出　　处：《中华全科医学》2019年第7期1112-1114,1170,共4页Chinese Journal of General Practice

基　　金：安徽省高等学校自然科学研究重点项目(KJ2015A248)

摘　　要：目的评价阿加曲班治疗急性脑梗死的临床疗效。方法选取蚌埠市第二人民医院2014年6月-2016年6月治疗的52例急性脑梗死患者,按随机数字表法分为2组,每组26例,治疗组给予常规药物(拜阿司匹林+阿托伐他汀,红花和小牛血),另外给予阿加曲班60 mg持续泵入,连用48 h,之后改为10 mg泵入,2次/d,连用5 d停用。对照组仅给予同治疗组的常规药物。在治疗后不同观察时间点运用美国国立卫生研究院卒中量表(NIHSS)评分和日常生活活动能力(BI)量表评分进行评估,并进行乳酸、hs-CRP、TNF-α、IL-6检测。结果治疗组治疗10 d后NIHSS评分明显下降,BI评分明显上升,与对照组比较差异有统计学意义(均P<0.05)。治疗前2组血乳酸、hs-CRP、TNF-α、IL-6比较差异无统计学意义(均P>0.05),治疗48 h、7 d,治疗组血乳酸、hs-CRP、TNF-α、IL-6水平比对照组明显降低,2组比较差异有统计学意义(均P<0.05)。2组血清活化部分凝血活酶时间(APTT)在治疗每个时间点差异有统计学意义(P<0.01),在10 d后2组比较差异无统计学意义(P>0.05)。结论阿加曲班可以有效改善脑组织血供,减少组织缺氧,减少炎性介质的释放,提高生存治疗,效果显著,可以作为良好的选择。Objective To evaluate the clinical efficacy of the argatroban in the treatment of acute cerebral infarction(ACI). Methods Total 52 cases of ACI in our hospital from June 2014 to June 2016 were enrolled and randomly divided into two groups with 26 cases in each group. The conventional drugs(bayaspirin, atorvastatin, safflower Injection and deproteinized hemoderivative of calf blood) were administrated in the control group, and additional argatroban(60 mg/day, continuous pump for 48 hours;then 10 mg/time, bid, pump for 5 days). The levels of lactic acid, hs-CRP, TNF-α and IL-6 were tested, and National institutes of health stroke scale(NIHSS) score and BI scale were conducted to evaluated the therapeutic efficacy at different time points. Results In the treatment group, NIHSS score decreased significantly, however, BI score increased significantly on d10 after the treatment, there were statistically difference when compared with the control group(P<0.05). There was no significant difference in the levels of lactic acid, hs-CRP, TNF-α and IL-6 before the treatment between the two groups(P>0.05). On 48 h and 7 d time points, these levels in the treatment group was significantly lower than that of the control group, there was significant difference between the two groups(P<0.05). The serum APTT on each time points were significantly different between the two groups(P<0.01), but there was no significant difference on 10 d after the treatment(P>0.05). Conclusion Argatroban can effectively improve the blood supply of brain tissue, relieve tissue hypoxia, reduce the release of inflammatory mediators, and improve survival. As one good choice for the ACI patients, the curative effect of argatroban is significant.

关 键 词：脑梗死 溶栓 阿加曲班注射液 美国国立卫生研究院卒中量表 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R973.2[医药卫生—临床医学]