阿加曲班联合尤瑞克林治疗急性脑梗死的临床疗效  

Clinical efficacy of argatroban combination with urinary kallidinogenase in the treatment of acute cerebral infarction

作　　者：董立丽[1] 郑文凤 解影 刘百巍 DONG Lili;ZHENG Wenfeng;XIE Ying;LIU Baiwei(Jilin Province Peoples Hospital,Changchun 130000,China;Center for Disease Control and Prevention in Jiamusi,Jiamusi 154000,China)

机构地区：[1]吉林省人民医院,吉林长春130000 [2]佳木斯市疾病预防控制中心,黑龙江佳木斯154000

出　　处：《中国实用神经疾病杂志》2024年第11期1327-1331,共5页Chinese Journal of Practical Nervous Diseases

基　　金：吉林省卫生健康委科技项目(编号:2013ZC036)。

摘　　要：目的探究阿加曲班联合尤瑞克林治疗急性脑梗死的效果及对神经功能恢复、脑血流灌注、血清血管内皮因子(VEGF)、白介素-33(IL-33)、超敏C反应蛋白(hs-CRP)水平的影响。方法选取吉林省人民医院2021-03—2024-03收治的92例急性脑梗死患者为研究对象,分为联合给药组和单一给药组各46例。单一给药组予以尤瑞克林治疗,联合给药组在单一给药组基础上予以阿加曲班治疗,2组患者均治疗30 d。比较2组患者神经功能恢复情况、脑血流灌注状态及实验室指标(VEGF、IL-33、hs-CRP)水平。结果治疗后,联合给药组患者美国国立卫生研究院卒中量表(NIHSS)评分为(6.22±1.78)分,低于单一给药组的(10.23±2.59)分,Barthel指数为(77.85±13.19)分,高于单一给药组的(62.76±14.08)分(t=8.654、5.305,P<0.05)。联合给药组患者的脑血流灌注指标脑血流通过时间(MTT)和峰值时间(TTP)分别为(6.17±2.71)s和(32.13±9.23)s,均低于单一给药组(7.59±2.45)s和(36.21±9.36)s,局部脑血流量(CBF)和脑血容量(CBV)分别为(72.8±13.6)mL/100 mg和(9.85±3.43)mL/100 mg,均高于单一给药组(62.4±14.9)mL/100 mg和(8.03±2.25)mL/100 mg(t=2.636、2.105、3.496、3.009,P<0.05)。联合给药组患者的实验室指标VEGF(238.12±30.65)ng/L,高于单一给药组(185.86±32.12)ng/L,血清IL-33和hs-CRP分别为(57.67±15.94)ng/L和(6.02±1.12)mg/L,均低于单一给药组(76.02±19.12)ng/L和(11.67±3.04)mg/L(t=7.983、4.000、11.828,P<0.05)。结论阿加曲班与尤瑞克林联合用药能够促进急性脑梗死患者神经功能恢复,积极改善脑血流灌注情况并减轻炎症反应及血管内皮损伤。Objective To investigate the effect of argatroban combined with urinary kallidinogenase in the treatment of patients with acute cerebral infarction and its influence on neurological function recovery,cerebral blood flow perfusion and serum vascular endothelial growth factor(VEGF),interleukin-33(IL-33)and high-sensitivity C-reactive protein(hs-CRP)levels.Methods A total of 92 patients with acute cerebral infarction in Jilin Province Peoples Hospital were selected from March 2021 to March 2024,and they were divided into combined administration group and single administration group,with 46 cases in each group.The single administration group was treated with urinary kallidinogenase,while the combined administration group was given argatroban for injection on the basis of the single administration group,and both groups were treated for 30 days.The neurological function recovery status,cerebral blood flow perfusion status and laboratory indicators(VEGF,IL-33,hs-CRP)were compared between the two groups.Results After treatment,the NIHSS score in the combined administration group was(6.22±1.78)points,which was lower than(10.23±2.59)points in the single administration group,while the Barthel index((77.85±13.19)points)was higher than the single administration group((62.76±14.08)points,t=8.654,5.305,P<0.05).The cerebral blood perfusion indicators of mean transit time(MTT)and time to peak(TTP)were(6.17±2.71)s and(32.13±9.23)s,respectively in the combined administration group,which were lower than(7.59±2.45)s and(36.21±9.36)s,respectively in the single administration group,while the local cerebral blood flow(CBF)and cerebral blood volume(CBV)((72.8±13.6)mL/100 mg,(9.85±3.43)mL/100 mg,respectively)were higher than the single administration group((62.4±14.9)mL/100 mg,(8.03±2.25)mL/100 mg,respectively,t=2.636,2.105,3.496,3.009,P<0.05).The laboratory indicator VEGF in the combined administration group was(238.12±30.65)ng/L,which was higher than(185.86±32.12)ng/L in the single administration group,while serum IL-33 an

关 键 词：急性脑梗死 阿加曲班 尤瑞克林 神经功能 脑血流灌注 炎症因子 

分 类 号：R743.33[医药卫生—神经病学与精神病学]