阿加曲班联合阿司匹林、氯吡格雷治疗进展型脑梗死患者临床疗效  

Clinical effect of argatroban combined with aspirin and clopidogrel in the treatment of patients with progressive cerebral infarction

作　　者：郑剑钧 赵超 陈志伟 Zheng Jianjun;Zhao Chao;Chen Zhiwei(Shangrao Municipal Hospital,Jiangxi 334000)

机构地区：[1]上饶市立医院,江西334000

出　　处：《天津药学》2023年第5期22-26,共5页Tianjin Pharmacy

摘　　要：目的:探究阿加曲班联合阿司匹林、氯吡格雷治疗进展型脑梗死(SIP)患者临床疗效。方法:选取2019年4月—2022年6月本院收治的90例SIP患者,采用随机数字表法分为对照组与观察组,各45例。两组均采取对症治疗,对照组在此基础上使用阿司匹林(ASP)联合氯吡格雷(CPDR)治疗,口服ASP 100 mg/次,1次/d;口服CPDR 75 mg/次,1次/d,两药联用10 d,同时采用氯化钠注射液静脉泵入持续5 d。观察组在对照组基础上增加阿加曲班(AGTB)治疗,60 mg AGTB与500 ml氯化钠注射液混合,微泵静脉点滴持续48 h,随后改用AGTB 10 mg+氯化钠注射液100 ml微泵静脉点滴,3 h/次,治疗5 d。比较两组临床疗效,治疗前后血液流变学指标、神经功能、日常生活能力以及不良反应发生率。结果:两组患者治疗后观察组总有效率显著高于对照组(P<0.05)。治疗前两组患者血小板最大聚集率、血小板最大聚集时间、纤维蛋白原(FIB)比较差异无统计学意义(P>0.05);治疗后两组患者血小板最大聚集时间较治疗前升高,血小板最大聚集率、纤维蛋白原(FIB)较治疗前降低(P<0.05),且观察组患者血小板最大聚集时间高于对照组,血小板最大聚集率、FIB水平低于对照组(P<0.05)。两组治疗前美国国立卫生研究院卒中量表(NIHSS)评分以及Barthel指数(MBI)评分比较差异无统计学意义(P>0.05);治疗后两组NIHSS评分较治疗前均有下降,MBI评分均有所上升(P<0.05);观察组患者的NIHSS评分显著低于对照组并且MBI评分显著高于对照组(P<0.05)。治疗后,两组不良反应总发生率比较差异无意义(P>0.05)。结论:AGTB联合ASP、CPDR治疗SIP临床疗效好,能有效降低患者血液流动指标,恢复患者神经功能,恢复患者日常生活能力,三药联用不良反应较少,具有较高安全性,值得推广。Objective:To explore the clinical efficacy of agatroban combined with aspirin and clopidogrel in treating patients with progressive cerebral infarction(SIP).Methods:A total of 90 patients with SIP admitted to the hospital from April 2019 to June 2022 were assigned to the control group and the observation group by random number table method,with 45 cases in each group.Both groups were treated with symptomatic treatment,and the control group was treated with aspirin(ASP)combined with clopidogrel(CPDR)on the basis of this treatment,ASP 100 mg/time,once/day.CPDR was orally administered 75 mg/time,once/day,combined with the two drugs for ten days,and sodium chloride injection was injected intravenously for five days.The observation group was additionally treated with agatroban(AGTB)on the basis of the control group:60 mg AGTB was mixed with 500 ml sodium chloride injection,micropump intravenous drip continued for 48 h;and then switched to AGTB 10 mg+sodium chloride injection 100 ml micropump intravenous drip,3 h/time,treatment for five days.The clinical efficacy,hemorheological indexes,neurological function,daily living ability,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the maximum platelet aggregation rate,maximum platelet aggregation time,and fibrinogen(FIB)between the two groups before treatment(P>0.05).After treatment,the maximum platelet aggregation time of the two groups was increased compared with that before treatment,and the maximum platelet aggregation rate and fibrinogen(FIB)were decreased compared with that before treatment(P<0.05).The maximum platelet aggregation time of the observation group was higher than that of the control group,and the maximum platelet aggregation rate and FIB levels were lower than that of the control group(P<0.05).There was no significant difference in the National Institutes of

关 键 词：阿加曲班 进展型脑梗死 血浆黏度 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]