阿加曲班联合氯吡格雷治疗短暂性脑缺血发作的临床研究  

Clinical study on argatroban combined with clopidogrel in treatment of transient ischemic attack

作　　者：陈丹丹[1] CHEN Dan-dan(Department of Cerebrovascular Diseases,First Teaching Hospital of Tianjin University of TCM,Tianjin 300380,China)

机构地区：[1]天津中医药大学第一附属医院脑血管病科

出　　处：《现代药物与临床》2019年第12期3573-3576,共4页Drugs & Clinic

摘　　要：目的探讨阿加曲班注射液联合硫酸氯吡格雷片治疗短暂性脑缺血发作的临床疗效。方法选取2016年1月-2018年12月天津中医药大学第一附属医院收治的205例短暂性脑缺血发作患者为研究对象,将所有患者根据危险因素分为对照组(80例)和治疗组(125例)。对照组晨起口服硫酸氯吡格雷片,75 mg/次,1次/d。治疗组在对照组治疗基础上加用阿加曲班注射液,60 mg/d,持续静脉泵注48 h,随后20 mg/次,2次/d,持续静脉泵注5 d,随后停用;两组患者治疗14 d。观察两组的临床疗效,比较两组的凝血指标、随访结果。结果治疗后,对照组和治疗组的总有效率分别为83.75%、91.20%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者纤维蛋白原(FIB)显著下降,凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)均明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者凝血指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的再发作率分别为17.50%、5.60%,恶化率分别为8.75%、3.20%,两组比较差异有统计学意义(P<0.05)。结论阿加曲班注射液联合硫酸氯吡格雷片治疗短暂性脑缺血发作具有较好的临床疗效,能调节凝血指标,降低再发作率和恶化率,具有一定的临床推广应用价值。Objective To explore the efficacy of Argatroban Injection combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of transient ischemic attack. Methods Patients(205 cases) with transient ischemic attack in the First Teaching Hospital of Tianjin University of TCM from January 2016 to December 2018 were randomly divided into the control group(80 cases) and the treatment group(125 cases). Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 75 mg/time, once daily. Patients in the treatment group were given Argatroban Injection on the basis of the control group, 60 mg/d, continuously intravenous pumped injection for 48 h, then 20 mg/time, twice daily, treated for 5 d. Patients in two groups wer e treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and co agulation index and follow-up results in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.75% and 91.20%, respectively, and there was difference between two groups(P < 0.05). After treatment, the FIB levels in two groups were significantly decreased, but the PT and the APTT levels in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the coagulation indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the recurrence rates in the control and treatment groups were 17.50% and 5.60%, respectively, and the deterioration rates in the control and treatment groups were 8.75% and 3.20%, respectively, and there was difference between two groups(P < 0.05).Conclusion Argatroban Injection combined with Clopidogrel Hydrogen Sulphate Tablets has clinical curative effect in treatment of transient ischemic attack, can adjust coagulation index, reduce recurrence rate and deterioration rate, which has a certain clinical application value.

关 键 词：阿加曲班注射液 硫酸氢氯吡格雷片 短暂性脑缺血发作 凝血功能 再发作率 恶化率 

分 类 号：R971[医药卫生—药品]