抗凝治疗进展性桥脑梗死临床观察  

Clinical observation of anticoagulation on progressive pontine infarction

作　　者：李丽 李光彩 赵蒙 庄肃敬 LI Li;LI Guangcai;ZHAO Meng;ZHUANG Sujing(Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院,山东临沂276400

出　　处：《中国实用神经疾病杂志》2020年第8期661-665,共5页Chinese Journal of Practical Nervous Diseases

基　　金：临沂市科研基金项目[编号:JB2019-2-89-(5)-R5]。

摘　　要：目的观察抗凝治疗急性期进展性桥脑梗死的临床疗效。方法选取符合纳入标准的进展性桥脑梗死患者62例,分为实验组(应用阿加曲班注射液治疗1组及应用低分子量肝素钙注射液治疗2组,为抗凝治疗组,42例)和对照组(应用拜阿司匹林肠溶片+氯吡格雷片治疗,为抗血小板聚集组,20例),观察比较2组治疗前后活化部分凝血活酶时间、凝血酶原时间、凝血酶时间、D-二聚体、纤维蛋白原及美国国立卫生院神经功能缺损评分、Rankin修订量表评分。结果治疗后实验1组较实验2组及对照组NIHSS、mRS评分均降低,差异有统计学意义(P<0.05)。实验组抗凝治疗后APTT、PT、TT均延长,静滴抗凝治疗比肌内注射抗凝治疗APTT、TT延长更明显。结论静滴抗凝治疗能有效降低急性期进展性桥脑梗死的严重程度及残疾程度。Objective To investigate the clinical effect of anticoagulation in the treatment of acute progressive pontine infarction.Methods 62 cases with progressive pontine infarction meeting the inclusion criteria were selected and divided into the experimental group(1 group treated with argatroban injection and 2 groups with low molecular weight heparin calcium injection,together as anticoagulant therapy group,42 cases)and the control group(applied aspirin enteric-coated tablets+clopidogrel tablets treatment group,antiplatelet aggregation group,20 cases).The activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),D-dimer(D-D),fibrinogen(FIB),and National Institute of Health stroke scale(NIHSS),modified Rankin Scale(mRS)before and after treatment and overall treatment effect were observed in the two groups.Results Compared with the experimental group 2 and the control group,the NIHSS and mRS scores of the experimental group were lower after treatment,and the differences were statistically significant.In the experimental group,APTT,PT,and TT were prolonged after anticoagulation treatment.The intravenous anticoagulation therapy was more prolonged than intramuscular anticoagulation therapy.Conclusion Intravenous anticoagulation therapy can effectively reduce the severity and disability of progressive pontine infarction in the acute phase.

关 键 词：阿加曲班 低分子量肝素钙 进展性脑梗死 氯吡格雷 阿司匹林 抗凝 

分 类 号：R743.33[医药卫生—神经病学与精神病学]