阿加曲班治疗穿支动脉粥样硬化病相关进展性卒中的临床效果  

Clinical effectiveness of argatroban in treating progressive stroke related to atherosclerotic disease of perforating branches

作　　者：李慧 邢付强 石进峰 赵尧辉 Li Hui;Xing Fuqiang;Shi Jinfeng;Zhao Yaohui(Department of Neurology,the First People's Hospital of Luoyang,Luoyang,Henan 471000,China)

机构地区：[1]洛阳市第一人民医院神经内科,河南洛阳471000

出　　处：《齐齐哈尔医学院学报》2024年第14期1337-1340,共4页Journal of Qiqihar Medical University

基　　金：洛阳市科技计划项目(2022032Y)。

摘　　要：目的评估阿加曲班治疗穿支动脉粥样硬化病相关进展性卒中的临床效果及安全性。方法回顾性分析2020年4月—2021年10月在本院神经内科确诊为穿支动脉粥样硬化病相关进展性卒中的92例患者临床资料,根据是否应用阿加曲班,分为阿加曲班组和对照组两组,每组各46例。阿加曲班组给予7 d阿加曲班联合双联抗血小板药物,对照组给予双联抗血小板药物。观察两组治疗不同时间点美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分的变化,治疗90 dmRS≤2分的比率,并记录相关出血事件。结果治疗后,阿加曲班组7 d评分为(4.33±2.37)分,低于对照组的(5.22±1.93)分,差异无统计学意义(P>0.05);阿加曲班组14 d NIHSS评分为(2.85±2.31)分,低于对照组的(4.17±1.84)分,差异有统计学意义(P<0.05);阿加曲班组14 d、90 d mRS评分分别为(2.15±0.87)分和(1.33±1.06)分,分别低于对照组的(2.56±0.69)分和(2.15±0.87)分,差异均有统计学意义(P<0.05)。阿加曲班组治疗90 d mRS≤2分的比率高于常规组(89.96%vs.65.22%,P<0.05)。阿加曲班组与对照组出血事件发生率比较,差异无统计学意义(6.52%vs.4.35%,P>0.05)。结论阿加曲班可明显改善穿支动脉粥样硬化病相关进展性卒中的神经功能缺损,并改善90 d功能预后,且不增加出血风险。Objective To estimate the efficacy and safety of argatroban in the treatment of progressive stroke that related to atheromatous disease in perforating branches.Methods The clinical data of 92 patients diagnosed with progressive stroke related to perforating branch atherosclerosis in the department of neurology of our hospital from April 2020 to October 2021 were retrospectively analyzed.According to the application of argatroban,they were divided into the argatroban group and the control group,with 46 cases in each group.Patients in argatroban group were given argatroban joint dual antiplatelet drugs for 7 days.The control group was given dual antiplatelet drugs.The changes of national Institutes of Health Stroke Scale(NIHSS)score and modified Rankin Scale(mRS)score at different time points of treatment were observed,the ratio of mRS≤2 after 90 days of treatment was observed,and the related bleeding events were recorded.Results After treatment,the 7-day score of argatroban group was(4.33±2.37),lower than(5.22±1.93)of the control group,however,the difference was not statistically significant(P<0.05).The NIHSS score of argatroban group at 14th day was(2.85±2.31),lower than(4.17±1.84)of the control group,and the difference was statistically significant(P<0.05).MRS score of argatroban group was(2.15±0.87)points and(1.33±1.06)points at 14th and 90th day,respectively,lower than(2.56±0.69)points and(2.15±0.87)points of the control group,the differences were statistically significant(P<0.05).The rate of mRS≤2 in the argatroban group was significantly higher than that in the conventional group(89.96%vs.65.22%,P<0.05).There was no difference in the incidence of bleeding events between the argatroban group and the control group(6.52%vs.4.35%,P>0.05).Conclusions Argatroban can significantly improve the neurological deficit induced by progressive stroke that related to atheromatous disease in perforating branches,and improve the 90-day functional outcome,without increasing the risk of bleeding.

关 键 词：阿加曲班 穿支动脉粥样硬化病 进展性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]