阿加曲班结合早期肠内营养支持对颅内动脉粥样硬化性狭窄脑梗死患者的疗效观察  

Effect of Argatroban Combined with Early Enteral Nutrition Support on Cerebral Infarction Patients with Intracranial Atherosclerotic Stenosis

作　　者：刘福友 孟彩丽 LIU Fuyou;MENG Caili(Department of Critical Care Medicine,Hebei Provincial Special Care Hospital,Shijiazhuang 050000,China;Department of Ultrasound,The First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北省优抚医院重症医学科,石家庄050000 [2]河北医科大学第一医院超声科,石家庄050000

出　　处：《宁夏医科大学学报》2025年第3期262-266,共5页Journal of Ningxia Medical University

基　　金：2023年度河北省医学科学研究课题计划项目(20231713)。

摘　　要：目的探讨阿加曲班结合早期肠内营养支持对颅内动脉粥样硬化性狭窄脑梗死患者的疗效。方法选择2021年5月至2023年5月收治的颅内动脉粥样硬化性狭窄脑梗死患者102例。根据不同治疗方法分为观察组(57例)和对照组(45例)。对照组采取硫酸氢氯吡格雷结合早期肠内营养支持治疗,观察组采取阿加曲班结合早期肠内营养支持治疗。比较两组患者治疗前及治疗1周后脑平均血流量(Q_(mean))、阻力指数(RI)、血流峰值时间(TTP)、美国国立卫生研究院卒中量表(NIHSS)评分、内皮素-1(ET-1)、神经生长因子(NGF)、N末端B型尿钠肽(NT-proBNP)变化、临床疗效及不良反应发生率。结果治疗前,两组患者Q_(mean)、RI、TTP、ET-1、NGF、NT-proBNP及NIHSS评分差异均无统计学意义(P均>0.05);观察组患者治疗1周后Q_(mean)、NGF高于对照组,RI、TTP、RI、TTP、ET-1、NT-proBNP及NIHSS评分均低于对照组(P均<0.05);观察组患者预后良好率为92.98%,对照组为77.78%,观察组高于对照组(P<0.05);两组患者不良反应发生率差异无统计学意义(P>0.05)。结论阿加曲班结合早期肠内营养支持可有效改善颅内动脉粥样硬化性狭窄脑梗死患者脑血流动力学与血清ET-1、NGF及NT-proBNP水平,并减轻神经功能缺损程度。Objective To investigate the effect of argatroban combined with early enteral nutrition support on patients with cerebral infarction and intracranial atherosclerotic stenosis.Methods From May 2021 to May 2023,102 patients with intracranial atherosclerotic stenotic cerebral infarction were selected.According to different treatment methods,they were divided into an observation group(57 cases)and a control group(45 cases).The control group received clopidogrel bisulfate combined with early enteral nutrition support treatment,while the observation group received argatroban combined with early enteral nutrition support treatment.The changes in mean cerebral blood flow(Q_(mean)),resistance index(RI),time to peak blood flow(TTP),National institute of health stroke scale(NIHSS)score,endothelin-1(ET-1),nerve growth factor(NGF),N-terminal B-type natriuretic peptide(NT-proBNP),clinical efficacy,and adverse reactions between the two groups before and 1 week after treatment were compared.Results Before treatment,there was no significant difference in Q_(mean),RI,TTP,ET-1,NGF,NT proBNP,and NIHSS scores between the two groups(P all>0.05).After one week of treatment,the Q_(mean) and NGF in the observation group were higher than those in the control group,while the scores of RI,TTP,RI,TTP,ET-1,NT proBNP and NIHSS in the observation group were lower than those in the control group(P all<0.05).The good prognosis rate of the observation group was 92.98%,which was higher than that of the control group(77.78%)(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Argatroban combined with early enteral nutrition support can effectively improve cerebral hemodynamics and serum levels of ET-1,NGF and NT proBNP in patients with cerebral atherosclerotic stenosis and cerebral infarction,and reduce the degree of neurological impairment.

关 键 词：阿加曲班 早期肠内营养支持 动脉粥样硬化 脑梗死 预后 

分 类 号：R541.4[医药卫生—心血管疾病]