阿加曲班对合并HHcy急性脑梗死患者血脂、炎症指标及神经系统功能的影响  

Effects of argatroban on blood lipids,inflammatory markers,and neurological function in patients with acute cerebral infarction complicated with hyperhomocysteinemia

作　　者：熊建 屈战利 任瑜 季一飞 XIONG Jian;QU Zhanli;REN Yu;JI Yifei(Neurology Department,Nanchong Central Hospital,Nanchong 637003,Sichuan,China)

机构地区：[1]南充市中心医院神经内科,四川南充637003

出　　处：《中南医学科学杂志》2024年第4期563-566,共4页Medical Science Journal of Central South China

基　　金：四川省自然科学基金(2022NSFSC0756)。

摘　　要：目的研究阿加曲班对合并高同型半胱氨酸血症(HHcy)急性脑梗死患者血脂、炎症指标及神经系统功能的影响。方法选取140例合并HHcy的急性脑梗死患者,随机均分为对照组(常规治疗)和观察组(阿加曲班+常规治疗)。分析各组血浆同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、总胆固醇(TC)、甘油三酯(TG)、美国国立卫生研究院卒中量表评分(NIHSS)、日常生活活动能力评分量表(Barthel指数)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)水平。分析治疗前Hcy、hs-CRP、HDLC、LDLC、TC、TG与NIHSS评分和Barthel指数的相关性。结果与治疗前比较,治疗后对照组和观察组血Hcy、hs-CRP、LDLC及TC均下降,且观察组低于对照组(P<0.05)。对照组PT、APTT于第5天升至正常范围,观察组于第3天即升至正常范围。在入院第2~4天时,观察组PT、APTT均明显高于对照组(P<0.05),而第6~7天两组PT、APTT比较差异无显著性(P>0.05)。与第1天比较,第7、30、90天两组NIHSS评分均降低,Barthel指数均升高;且观察组较对照组变化更为显著(P<0.05)。血Hcy水平、hs-CRP、LDLC与NIHSS呈正相关,与Barthel指数呈负相关(P<0.05)。结论阿加曲班可显著降低HHcy急性脑梗死患者血脂、Hcy及炎症水平,改善患者凝血功能,加快神经功能及生活能力恢复。Aim To investigate the impact of argatroban on lipid profiles,inflammatory markers,and neurological function in acute cerebral infarction patients with hyperhomocysteinemia(HHcy).Methods A total of 140 acute cerebral infarction patients with HHcy were selected and randomly divided into two groups,namely the control group(standard treatment)and the observation group(argatroban+standard treatment).We analyzed plasma homocysteine(Hcy),hyper-sensitivity C-reactive protein(hs-CRP),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),total cholesterol(TC),triglycerides(TG),national institutes of health stroke scale(NIHSS)scores,Barthel index scores,prothrombin time(PT),and activated partial thromboplastin time(APTT).We then analyzed the correlation between Hcy,hs-CRP,HDLC,LDLC,TC,TG,NIHSS scores,and Barthel index before treatment.Results Compared with the pre-treatment levels,post-treatment levels of Hcy,hs-CRP,LDLC,and TC were decreased in both groups,with the observation group showing significantly lower levels than the control group(P<0.05).PT and APTT returned to normal ranges by day 5 in the control group and by day 3 in the observation group.PT and APTT were significantly higher in the observation group than in the control group on days 2-4(P<0.05),but no significant differences were observed between the two groups on days 6-7(P>0.05).NIHSS scores were decreased and Barthel index scores were increased on days 7,30,and 90 in both groups compared with those on day 1,with more significant improvements in the observation group(P<0.05).Hcy,hs-CRP,and LDLC levels were positively correlated with NIHSS scores and negatively correlated with Barthel index scores(P<0.05).Conclusion Argatroban significantly reduces lipid levels,Hcy,and inflammation in acute cerebral infarction patients with HHcy,improves coagulation function,and accelerates the recovery of neurological function and daily living activities.

关 键 词：阿加曲班 急性脑梗死 高同型半胱氨酸血症 

分 类 号：R743[医药卫生—神经病学与精神病学]