低剂量阿加曲班联合阿替普酶治疗急性缺血性卒中的疗效观察  

Effect of Low Dose Argatroban Combined with Alteplase on Acute Cerebral Infarction

作　　者：陈艳秋 苟怀宇 CHEN Yanqiu;GOU Huaiyu(Department of Neurology,Yubei District People’s Hospital,Chongqing 401120,China)

机构地区：[1]重庆市渝北区人民医院神经内科,重庆401120

出　　处：《中国医药指南》2025年第6期92-95,共4页Guide of China Medicine

摘　　要：目的探讨低剂量阿加曲班联合阿替普酶治疗急性缺血性卒中(AIS)的治疗效果。方法选取2019年1月至2023年3月本院神经内科收治的急性缺血性卒中患者60例,按随机数字表法分为治疗组(30例)和对照组(30例)。治疗组患者接受低剂量阿加曲班联合阿替普酶治疗,对照组患者接受阿替普酶治疗。比较两组治疗前和治疗后APTT值、美国国立卫生院卒中量表(NIHSS)评分、改良Rankin评分(mRS)及不良反应发胜率。结果两组治疗后的APTT值均较治疗前增加,但均在安全范围内,而治疗组在治疗后2 h、12 h、24 h的APTT值比对照组高(P<0.05)。两组治疗前、治疗后2 h和24 h的NIHSS评分比较无统计学意义(P>0.05),但在治疗后7 d和90 d,治疗组的NIHSS评分低于对照组(P<0.05)。治疗后7 d和90 d,治疗组的mRS评分低于对照组(P<0.05)。两组的出血等不良反应无统计学意义(P>0.05)。结论发病时间<4.5 h的AIS接受标准阿替普酶静脉溶栓后,给予低剂量阿加曲班持续静脉泵入24 h,无明显增加出血风险,有利于改善AIS患者神经功能,提高疗效。Objective To investigate the therapeutic effect of low-dose argatroban combined with alteplase in the treatment of acute ischemic stroke(AIS).Methods A total of 60 patients with AIS admitted to the neurology department of our hospital from January 2019 to March 2023 were selected and divided into the treatment group(30 cases)and the control group(30 cases)by random number table method.The treatment group received low-dose argatroban combined with alteplase treatment,while the control group received alteplase treatment.APTT values,National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin score(mRS)and adverse reaction probability were compared between the two groups before and after treatment.Results The APTT values of the two groups after treatment were increased compared with those before treatment,but all were within the safe range,and the APTT values of the treatment group at 2 hours,12 hours and 24 hours after treatment were higher than those of the control group(P<0.05).There was no significant difference in NIHSS scores between the two groups before treatment,2 hours and 24 hours after treatment(P>0.05),but at 7 days and 90 days after treatment,NIHSS scores in the treatment group were lower than those in the control group(P<0.05).At 7 days and 90 days after treatment,mRS Scores in the treatment group were lower than those in the control group(P<0.05).There was no statistical significance in adverse reactions such as bleeding between the two groups(P>0.05).Conclusions AIS patients with onset time<4.5 hours who receive standard alteplase intravenous thrombolysis are given low-dose argatroban continuously intravenously for 24 hours without significantly increasing the risk of bleeding,which is beneficial for improving the neurological function of AIS patients and enhancing therapeutic efficacy.

关 键 词：阿加曲班 阿替普酶 急性缺血性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]