进展性急性期脑梗死患者采用COX-1抑制剂结合阿加曲班治疗的疗效及其对血清LPA、GFAP水平的影响  

The efficacy of COX-1 inhibitor combined with agatroban in the treatment of patients with progressive acute cerebral infarction and its impact on serum LPA and GFAP levels

作　　者：胡译丹 汪侃 Hu Yidan;Wang Kan(Yongcheng People′s Hospital,Shangqiu,Henan 476600)

机构地区：[1]永城市人民医院,河南商丘476600

出　　处：《辽宁医学杂志》2024年第1期37-40,共4页Medical Journal of Liaoning

摘　　要：目的阿加曲班联合COX-1抑制剂(阿司匹林)对进展性急性期脑梗死治疗疗效及对神经功能评分、生活能力指数评分和血清血磷脂酸(LPA)、胶质纤维酸性蛋白(GFAP)水平影响。方法前瞻性选择我院神经内科2019年6月至2021年6月诊治的进展性急性期脑梗死病人80例。全部病人利用简单数字随机分组法分成2组。对照组40例病人口服COX-1抑制剂(阿司匹林)治疗,治疗组40例病人使用阿加曲班联合COX-1抑制剂(阿司匹林)治疗。比较2组患者治疗疗效及对神经功能评分、生活能力指数评分、血清LPA、GFAP水平及不良反应。结果总有效率方面,治疗组(95%)较对照组病人(77.50%)高(P<0.05)。Barthel指数、NIHSS评分方面,2组病人治疗前对比无差异(P>0.05)。2组病人治疗14d,NIHSS评分较治疗前下降(P<0.05),而Barthel指数则较治疗前上升(P<0.05)。治疗14d,治疗组患者NIHSS(25.47±4.02)分低于对照组(P<0.05),Barthel指数(52.99±6.03)高于对照组(P<0.05)。治疗前,2组LPA、GFAP水平对比无差异(P>0.05)。2组病人治疗14d的LPA浓度水平较治疗前下降(P<0.05),GFAP水平高于治疗前(P<0.05)。治疗14d,治疗组患者LPA(1.28±0.21)u/L低于对照组(P<0.05),GFAP(4.98±0.99)pg/ml较对照组病人高(P<0.05)。治疗14d,不良反应出现概率方面,治疗组(20.00%)较对照组(47.50%)低(P<0.05)。结论阿加曲班联合COX-1抑制剂(阿司匹林)治疗进展性急性期脑梗死能通过降低血清LPA、GFAP水平改善患者的神经功能及生活能力,降低不良反应率,进而提升治疗效果,建议使用。Objective To investigate the effects of agattroban combined with COX-1 inhibitor(aspirin)on neurological function score, living ability index score and serum lysophosphatidic acid(LPA)and glial fibrillary acidic protein(GFAP)levels in patients with acute progressive cerebral infarction.Methods Eighty patients with acute progressive cerebral infarction diagnosed and treated in Neurology Department of our hospital from June 2019 to June 2021 were prospectively selected.Patients were randomly classified into two groups via numeral grouping methods, each with 40 cases.Control group received aspirin, based on this, treatment group received agattroban.Then comparison was conducted on clinical efficacy, National Institutes of Health Stroke Scale(NIHSS)score, Barthel Index, serum levels of LPA、GFAP and adverse reactions.Results Compared with control group, treatment group achieved higher clinical efficacy rate(95%),with statistical difference(P<0.05).Baseline NIHSS and Barthel index yielded no statistical difference between two groups(P>0.05).At post-treatment 14d, a decrease in NIHSS score along with an increase in Barthel index were observed in both groups, and treatment group scored lower on NIHSS(25.47±4.02)and higher on Barthel Index(52.99±6.03)than those of control group(P<0.05).Serum levels of LPA and GFAP demonstrated no significant difference between two groups before treatment(P>0.05),while a decrease in LPA level and an increase in GFAP were found in both groups at post-treatment 14d(P<0.05),and treatment group had lower LPA(1.28±0.21)u/L and higher GFAP(4.98±0.99)pg/ml levels than those of control group(P<0.05).At post-treatment 14d, 20.00% of adverse reactions in the treatment group were significantly lower than 47.50% in the control group(P<0.05).Conclusion Application of agattroban combined with COX-1 inhibitor aspirin in the treatment of acute progressive cerebral infarction can effectively reduce the serum levels of LPA and GFAP,reduce adverse reaction rate and ameliorate the neurological function

关 键 词：阿加曲班 阿司匹林 进展性急性期脑梗死 疗效 神经功能 LPA GFAP 

分 类 号：R743.33[医药卫生—神经病学与精神病学]