阿加曲班注射液治疗进展性脑梗死的疗效观察

Curative observation of Argatroban Injection in treatment of progressive cerebral infarction

目的观察阿加曲班注射液治疗进展性脑梗死的临床疗效和安全性。方法将100例进展性脑梗死患者随机分为治疗组（50例）和对照组（50例）,两组均给以活血化瘀、清除自由基、改善脑代谢、控制血压和血糖等常规治疗,均给予依达拉奉,30 mg/次,用100 mL生理盐水稀释,30 min内滴完,2次/d。治疗组在此基础上加用阿加曲班注射液,第1、2天每天用阿加曲班60 mg,以750 mL生理盐水稀释,24 h持续静脉滴注;其后5 d每天用阿加曲班10 mg以100~250 mL生理盐水稀释,分早晚2次持续静脉滴注,每次3 h。对照组使用低分子肝素钙,4 100 U/次,每12小时腹部皮下注射一次,两组均治疗14 d。治疗前后使用NIHSS评分比较两组神经功能障碍程度,Barthel指数评价康复情况,统计两组临床治疗的总有效率,同时观察两组患者的不良反应。结果两组治疗后14 d NIHSS评分均明显低于治疗前（P〈0.05）。治疗后,治疗组较对照组NIHSS评分有显著改善（P〈0.05）,治疗组与对照组总有效率分别为98%、72%,两组比较差异有统计学意义（P〈0.05）。两组均无不良反应发生。结论阿加曲班注射液对进展性脑梗死有较好的治疗效果,且无不良反应发生。

Objective To evaluate the efficacy and safety of Argatroban Injection in the treatment of progressive cerebral infarction.Methods The patients（100 cases） diagnosed as progressive cerebral infarction were randomly divided into treatment（50 cases） and control（50 cases） groups.The two groups were given the treatment to improve blood circulation,remove free radicals,improve cerebral metabolism,and control blood pressure and sugar.They were iv administered with edaravone（30 mg） added into 100 mL physiological saline,and drop within 30 min,twice daily.In addition,the treatment group was treated with Argatroban Injection（60 mg diluted with 750 mL physiological saline） through 24 h continuous iv pump infusion on the first 2 d.The next 5 d they were treated with Argatroban Injection（10 mg diluted with 100—250 mL physiological saline）,through continuous 3 h iv infusion twice daily in the morning and evening.The patients in the control group were treated with low molecular weight heparin,4 100 U/time,and they were administered with abdominal sc injection every 12 h.Two groups were treated for 14 d.The degrees of neurological deficits were evaluated by NIHSS scoring and the rehabilitation was evaluated by Barthel index before and after the treatment.The efficiency and adverse reactions were observed.Results Within 14 d after the treatment,the NIHSS scores of the two groups were significantly lower than those before the treatment（P 0.05） and the difference between the two groups was statistically significant（P 0.05）.The efficiency for the patients both in the treatment and control groups was 98% and 72% with the significant difference（P 0.05）.There was no adverse reaction in the two groups.Conclusion Argatroban Injection has a accurate curative effect on the progressive cerebral infarction,which has no adverse reaction.