阿加曲班和低分子肝素钙治疗大动脉粥样硬化型进展性脑梗死疗效观察  

Efficacy of agatroban and low-molecular-weight heparin calcium on large artery atherosclerosis progressive cerebral infarction

作　　者：涂加善[1] 赖舒帆[1] 钟锐[1] 周坤元[1] 成刚卫 TU Jiashan;LAI Shufan;ZHONG Rui(Dept.of Neurology,Meizhou People’s Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院神经内科,广东梅州514031

出　　处：《华夏医学》2019年第5期28-32,共5页Acta Medicinae Sinica

基　　金：梅州市医药卫生科研项目(2017-B-33)。

摘　　要：目的:观察阿加曲班和低分子肝素钙治疗大动脉粥样硬化(LAA)型进展性脑梗死(PCI)的有效性及安全性。方法:回顾性纳入114例大动脉粥样硬化型PCI患者,根据治疗方法分为3组:A组53例,在常规治疗基础上加用阿加曲班;B组22例,在常规治疗基础上加用低分子肝素钙;C组39例,采用常规治疗。疗程均为7 d。比较3组患者治疗后14 d的临床疗效和出血事件发生情况。结果:治疗14 d后,A组患者的治疗总有效率为54.7%,高于C组的33%;A组患者的NIHSS评分为(6.92±4.17)分,低于C组的(9.16±6.26)分,差异均有统计学意义(P<0.05)。B组患者的治疗总有效率为59.1%,明显高于C组的33%;B组患者的NIHSS评分为(6.18±3.80)分,低于C组的(9.16±6.26)分,差异均有统计学意义(P<0.05);A组和B组的总有效率和NIHSS评分差异均无统计学意义(P>0.05)。A组患者的出血事件发生率为3.8%,高于B组的0.0%和C组的2.6%,但差异均无统计学意义(P>0.05)。结论:阿加曲班和低分子肝素钙治疗大动脉粥样硬化型PCI均有效、安全,且两种药物疗效无明显差别。Objective:To observe the efficacy and safety of argatroban and low-molecular-weight heparin calcium in the treatment of large atery atherosclerotic progressive cerebral infarction(PCI).Methods:114 patients with large artery atherosclerotic PCI were retrospectively included.According to the treatment method,they were divided into 3 groups.Group A:53 patients were treated with argatroban on the basis of the conventional treatment;Group B:22 patients were treated with low-molecular-weight heparin calcium on the basis of conventional treatment;Group C:39 patients received conventional treatment.The course of treatment was 7 days.The clinical efficacy and the occurrence of bleeding events on 14 days after treatment were compared among the 3 groups.Results:After 14 days of treatment,the total effective rate of Group A was 54.7%,significantly higher than 33%of Group C;NIHSS score of Group A was 6.92±4.17,significantly lower than 9.16±6.26 of group C,which were of statistical differences(P<0.05).The total effective rate of Group B was 59.1%,significantly higher than 33%of Group C(P<0.05);NIHSS score of Group B was 6.18±3.80,significantly lower than 9.16±6.26 of Group C,which were of statistical differences(P<0.05).There was no significant difference in total effective rate and NIHSS score between Group A and B(P>0.05).The incidence of bleeding events in Group A was 3.8%,higher than 0.0%in Group B and 2.6%in Group C,but there was no significant differences among them(P>0.05).Conclusion:Argatroban and low-molecular-weight heparin calcium were both effective and safe in the treatment of large artery atherosclerotic PCI,and there is no significant difference between the two drugs.

关 键 词：阿加曲班 低分子肝素 动脉粥样硬化 进展性脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]