阿加曲班与纤溶酶治疗急性缺血性脑卒中的安全性和有效性对比  

Comparison of Safety and Efficacy ofArgatroban and Plasmin in the Treatment ofAcute Ischemic Stroke

作　　者：胡素娟 孙慧[1] 徐丽芳 李灵玲 周搏 郭晓玲[1] HU Su-juan;SUN Hui;XU Li-fang;LI Ling-ling;ZHOU Bo;GUO Xiao-ling(Department of Neurology 981 Hospital of PLA Joint Logistic Support Force,Chengde,Hebei,067000,China;Chengde Medical University)

机构地区：[1]中国人民解放军联勤保障部队第九八一医院神经内科,河北承德067000 [2]承德医学院

出　　处：《承德医学院学报》2023年第2期104-108,共5页Journal of Chengde Medical University

基　　金：承德市科技局项目(编号201804A046)。

摘　　要：目的 比较阿加曲班与纤溶酶治疗急性缺血性脑卒中(AIS)患者的安全性及有效性。方法 收集168例发病48h内不符合静脉溶栓的AIS患者随机分为阿加曲班组和纤溶酶组。前者在常规抗血小板治疗基础上,予以阿加曲班注射液静脉滴注共7d;后者在常规抗血小板治疗基础上,给予纤溶酶静脉滴注共10d。评价患者治疗前、1周后美国国立卫生院脑卒中量表评分(NHISS)及3个月随访时改良Rankin(m RS)评分,了解神经功能改变情况及预后。同时行治疗前后的颅脑CT/MRI及血生化、凝血等检查排除不良事件发生(包括症状性颅内出血及其他脏器出血)。结果 阿加曲班组及纤溶酶组AIS患者治疗1周后较治疗前NHISS评分均显著下降(P<0.01);随访3个月后mRS均显著降低(P<0.05)。阿加曲班组治疗1周后临床总有效率显著高于纤溶酶组(P<0.05)。2组治疗1周后复查颅脑CT及生化等相关化验指标提示均未出现不良事件(P>0.05)。结论 AIS患者早期应用阿加曲班与纤溶酶均可改善神经系统功能缺损,且2组均未增加不良事件的发生,阿加曲班临床疗效更佳。Objective Tocompare the safety and efiacy ofagatoban andplasmnin in the ratment ofpatints with acute ischemic stroke(AIS).Methods A total of 168 patients with AIS who were not eigible for itrvenours thrombolysis within 48 hours ofonset were randomly divided into angatroban group andplasmin group.The former was given itravenous ifiusin ofAgatroban ijiction for 7 days on the basis of conventional anipltelete therapy;the ltter was given intravenous infusion of plasmin for 10 days on the basis ofonvenional aniplatelet therapy.The National Istitutes ofHalthStroke Scale(NHISS)score and hemified Rankin(mRS)soore at 3-month fllwup were evaluated belfore tratment and 1 weck afer treatment to understand the changes of neurological finction and prognosis.At the same time,cranial CTMRI,blood biochemistry,coagulation and other examinations before and after treatment were peformed to exchude adverse events(nchuding symplomatic inta cranial hemohage and other ongan hemonrhage).Results The NHISS socores of the AIS patients in the angatroban group and plasmin group were significanty decreased afier 1 week of treatment compared with those befre treatment(P<0.01);the mRS was signifcanty decreased afer 3 months of followup(P<0.05).The total clinical efective rate in the agatroban group was signifcanty higher than that in the plasmin group afer 1 week of treatment(P<0.05).Afer 1 week treatment of the two groups,the re examination of cranial CT and biochemical test indicators showed that there were no adverse events(P>0.05).Concusion Early application of angatroban and plasmin in AIS patients can improve neurological deficis,and the two groups do not increase the ocumrence of adverse events,and the clinical eficacy of angatroban is better.

关 键 词：急性缺血性脑卒中 阿加曲班 纤溶酶 抗血小板聚集 

分 类 号：R743.3[医药卫生—神经病学与精神病学]