奥拉西坦联合阿加曲班注射液治疗急性脑梗死的临床疗效观察

Clinical curative observation of oxiracetam combined with Argatroban Injection in treatment of acute cerebral infarction

目的观察奥拉西坦联合阿加曲班注射液治疗急性脑梗死的临床疗效。方法 2011年7月—2013年6月在铜陵市人民医院住院的急性脑梗死患者80例随机分为治疗组(40例)和对照组(40例)。对照组在活血化瘀、清除自由基、抗血小板聚集及控制血压及血糖、吸氧、针灸、康复锻炼等一般治疗基础上加用奥拉西坦3 g+5%葡萄糖注射液或生理盐水250mL,静脉滴注,1次/d。治疗组给予阿加曲班注射液,第1、2天每天用阿加曲班注射液60 mg,以500 mL生理盐水稀释,24 h持续静脉滴注;其后5 d每天用阿加曲班注射液10 mg,以250 mL生理盐水稀释,分早晚2次持续静脉滴注,每次3h,其他同对照组,两组均连续治疗14 d。两组治疗前,治疗第7、14天进行CSS评分并记录治疗过程中出现的不良反应。结果两组治疗第7、14天与治疗前比较CSS评分均明显降低,差异有统计学意义(P<0.05);治疗后,治疗组较对照组降低更明显,两组差异有统计学意义(P<0.05)。治疗组与对照组总有效率分别为90.0%、77.5%,两组比较差异有统计学意义(P<0.05)。两组患者均无不良反应发生。结论奥拉西坦联合阿加曲班注射液治疗急性脑梗死临床疗效较好,且安全有效,值得临床推广。

Objective To observe the clinical effect of oxiracetam combined with Argatroban Injection in the treatment of acute cerebral infarction. Methods The patients （80 cases） diagnosed as acte cerebral infarction in People＇s Hospital of Tongling from July 2011 to June 2013 were randomly divided into treatment （40 cases） and control （40 cases） groups. Patients in the control group were given the treatment for improving blood circulation, removing free radicals, anti-platelet aggregation, and controling blood pressure and blood sugar, and at the same time they were given oxygen, acupuncture, and rehabilitation exercises. In addition, the patients in the control group were iv administered with oxiracetam （3 g） added into 5% glucose injection （250 mL） or physiological saline, once daily. The patients in the treatment group were treated with Argatroban Injection （60 mg diluted with 500 mL physiological saline） through 24 h continuous iv infusion on the first 2 d. The next 5 d they were treated with Argatroban Injection （10 mg diluted with 250 mL physiological saline）, through continuous 3 h iv infusion twice daily in the morning and evening, and the other treatment was the same as the control group. The patients in the two groups were treated for 14 d. CSS scoring and adverse reactions were observed and evaluated after the treatment for 7 d and 14 d. Results Within 7 d and 14 d after the treatment, the CSS scores of the patients in 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 were 90.0% and 77.5% with the significant difference （P 〈 0.05）. There was no adverse reaction in the two groups. Conclusion Oxiracetam combined with Argatroban Injection in the treatment of acute cerebral infarction is safe and effective, which is worthy to be popularized.