阿加曲班联合阿替普酶静脉溶栓治疗急性脑梗死的临床疗效及其对脑血流动力学的影响  

Clinical effect of argatroban combined with intravenous thrombolysis with alteplase for acute cerebral infarction and the impact on cerebral hemodynamics of patients

作　　者：王洲 周冬梅 孙承霞 WANG Zhou;ZHOU Dongmei;SUN Chengxia(Anlu Puai Hospital,Anlu 432600,China)

机构地区：[1]湖北省安陆市普爱医院,432600

出　　处：《临床合理用药杂志》2023年第6期15-18,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察阿加曲班联合阿替普酶静脉溶栓治疗急性脑梗死的临床疗效及其对脑血流动力学的影响。方法 回顾性选取安陆市普爱医院2020年8月—2021年8月收治的80例急性脑梗死患者作为研究对象,根据治疗方法分为对照组和试验组,各40例。2组患者均接受常规治疗,对照组患者在常规治疗基础上接受阿替普酶静脉溶栓治疗2周,试验组患者在对照组基础上联合阿加曲班治疗1周。比较2组临床疗效,治疗前、治疗结束后血清学指标[B型脑钠肽(BNP)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)]、脑血流动力学指标(颈动脉平均血流量、外周阻力、特性阻抗及平均血流速度)及不良反应发生率。结果 试验组总有效率为97.50%,高于对照组的85.00%(χ^(2)=3.914,P=0.048)。治疗结束后,试验组血清BNP、CRP、Hcy水平均低于对照组(P<0.01)。治疗结束后,2组颈动脉的平均血流量、平均血流速度高于治疗前,颈动脉的外周阻力及特性阻抗低于治疗前,且试验组颈动脉的平均血流量、平均血流速度高于对照组,颈动脉的外周阻力及特性阻抗低于对照组(P<0.05或P<0.01)。对照组治疗期间不良反应总发生率为2.50%,与试验组的7.50%比较,差异无统计学意义(χ^(2)=0.263,P=0.608)。结论 阿加曲班联合阿替普酶静脉溶栓治疗急性脑梗死的效果确切,可更有效减轻血管内皮损伤,改善脑血流动力学,且安全性较高。Objective To discuss the clinical effect of argatroban combined with intravenous thrombolysis with alteplase for acute cerebral infarction and the impact on cerebral hemodynamics of patients. Methods A total of 80 cases of patients with acute cerebral infarction were selected from August 2020 to August 2021 in Anlu Puai Hospital, and they were divided into the control group and the experimental group, 40 cases in each group.All patients were given conventional therapy, and patients in the control group were given intravenous thrombolysis with alteplase for 2 weeks, and patients of the experimental group were given argatroban for 1 week based on the control group. Clinical effect, serological indexes(BNP, CRP, Hcy) after treatment, cerebral hemodynamics indexes(average carotid blood flow, peripheral resistance, characteristic impedance and average blood flow velocity) before and after treatment, incidence of adverse reactions were compared between the two groups. Results Total effective rate of the experimental group was 97.50%, which was higher than 85.00% of the control group(χ^(2)=3.914, P=0.048). After treatment, serum levels of BNP, CRP, Hcy of the experimental group were lower than those of the control group(P<0.01). After treatment, average carotid of blood flow, average blood flow velocity of the two groups were higher than those before treatment, average carotid of peripheral resistance, characteristic impedance were lower than those before treatment, and average carotid of blood flow, average blood flow velocity of the experimental group were higher than those of the control group, average carotid of peripheral resistance, characteristic impedance were lower than those of the control grouo(P<0.05 or P<0.01). There was no significant difference of the incidence of adverse reactions between the control group(2.50%) and the experimental group(7.50%)(χ^(2)=0.263, P=0.608). Conclusion Agatroban combined with intravenous thrombolysis with alteplase is effective in the treatment of acute cerebral infarction,

关 键 词：急性脑梗死 阿加曲班 阿替普酶 溶栓 血流动力学 B型脑钠肽 C反应蛋白 同型半胱氨酸 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]