阿加曲班序贯疗法联合rt-PA溶栓治疗急性缺血性脑卒中患者的临床疗效  

Clinical Efficacy of Argatroban Sequential Therapy Combined with rt-PA Thrombolysis in the Treatment of Acute Ischemic Stroke

作　　者：徐小隔 李静雪 魏孟丽 XU Xiaoge;LI Jingxue;WEI Mengli(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000)

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450000

出　　处：《医学临床研究》2024年第3期406-409,共4页Journal of Clinical Research

摘　　要：【目的】探讨阿加曲班序贯疗法联合阿替普酶(rt-PA)溶栓治疗急性缺血性脑卒中(AIS)患者的临床疗效。【方法】回顾性分析2020年5月至2022年12月本院收治的96例AIS患者的临床资料,根据治疗方案的不同将其分为观察组和对照组,每组48例。对照组给予rt-PA溶栓治疗,观察组在溶栓基础上给予阿加曲班序贯疗法。对比两组疗效、神经功能损伤因子[S100β蛋白、神经元特异性烯醇化酶(NSE)]、血管内皮损伤指标[血清降钙素基因相关肽(CGRP)、内皮素-1(ET-1)]、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Barthel指数(BI)评分及并发症发生情况。【结果】治疗3个月后,观察组总有效率高于对照组(P<0.05);治疗14 d、3个月后,观察组S100β、NSE均低于对照组(P<0.05);治疗14 d、3个月后,观察组CGRP高于对照组,ET-1低于对照组(P<0.05);治疗3个月后,观察组NIHSS、mRS评分低于对照组,BI评分高于对照组(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】阿加曲班序贯疗法联合阿替普酶治疗AIS患者效果显著,可减少血管内皮损伤,改善神经功能,提高患者生活能力。【Objective】To investigate the clinical efficacy of argatroban sequential therapy combined with alteplase(rt-PA)thrombolysis in the treatment of acute ischemic stroke(AIS).【Methods】The clinical data of 96 patients with AIS treated in our hospital from May 2020 to December 2022 were retrospectively analyzed.According to the different treatment schemes,they were divided into observation group and control group,with 48 cases in each group.The control group was given rt-PA thrombolysis,while the observation group was given argatroban sequential therapy on the basis of thrombolysis.The efficacy,neurological injury factors[S100βprotein,neuron specific enolase(NSE)],vascular endothelial injury indicators[serum calcitonin gene-related peptide(CGRP),endothelin-1(ET-1)],National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS),Barthel Index(BI)score and the incidence of complications were compared between the two groups.【Results】After 3 months of treatment,the total effective rate of the study group was higher than that of the control group(P<0.05);After 14 days and 3 months of treatment,S100βand NSE in the observation group were lower than those in the control group(P<0.05);After 14 days and 3 months of treatment,CGRP in the observation group was higher than that in the control group,and ET-1 was lower than that in the control group(P<0.05);After 3 months of treatment,the NIHSS and mRS scores of the observation group were lower than those of the control group,and the BI score of the observation group was higher than that of the control group(P<0.05);There was no significant difference in the total incidence of complications between the two groups(P>0.05).【Conclusion】The effect of argatroban sequential therapy combined with alteplase in the treatment of AIS is significant,which can reduce vascular endothelial injury,improve neurological function and improve living ability.

关 键 词：脑缺血 卒中 急性病 组织型纤溶酶原激活物/治疗应用 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]