阿加曲班对急性脑梗死患者脑血流及CXCL16、hsCRP水平的影响

Influence of argatroban on cerebral blood flow,levels of CXCL16 and hsCRP in patients with acute cerebral infarction

目的:探究阿加曲班对急性脑梗死(ACI)患者脑血流及CXC趋化因子配体16(CXCL16)、高敏C反应蛋白(hsCRP)水平的影响。方法:选择ACI患者共100例,随机均分为常规治疗组和阿加曲班组(在常规治疗基础上联合阿加曲班治疗)。治疗10d,对比两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分,脑血流及CXCL16、hsCRP水平等变化的情况。结果:与治疗前比较,治疗后两组NIHSS评分、内皮素(ET)-1、CXCL16和hsCRP水平均明显降低,大脑中动脉(MCA)和大脑前动脉(ACA)平均血流速度明显提高,一氧化氮(NO)水平明显升高(P均=0.001),且与常规治疗组比较,阿加曲班组治疗后NIHSS评分[(9.78±3.59)分比(7.02±3.67)分]、ET-1[(75.75±10.67)pg/ml比(62.56±9.45)pg/ml]、CXCL16[(2.01±0.84)ng/ml比(1.67±0.75)ng/ml]和hsCRP[(4.42±1.66)mg/L比(3.89±1.37)mg/L]水平降低更显著,MCA[(48.87±5.23)cm/s比(55.35±6.35)cm/s]、ACA[(41.25±4.89)cm/s比(47.88±5.47)cm/s]平均流速显著提高,NO[(55.77±6.36)μmol/L比(65.76±6.86)μmol/L]水平明显升高(P<0.05或<0.01)。两组出血事件发生率无显著差异(P=0.315)。结论:在常规治疗基础上加用阿加曲班可更有效提高脑血流,改善血管内皮功能,降低CXC趋化因子配体16、高敏C反应蛋白水平,提高临床疗效。

Objective：To explore influence of argatroban on cerebral blood flow,levels of CXC chemokine ligand 16（CXCL16）and high sensitive C reactive protein（hsCRP）in patients with acute cerebral infarction（ACI）.Methods：A total of100 ACI patients were selected,randomly and equally divided into routine treatment group and argatroban group（received argatroban based on routine treatment）,both groups were treated for 10 d.Score of United States national institutes of health stroke score（NIHSS）,cerebral blood flow and levels of CXCL16 and hsCRP were compared between two groups before and after treatment.Results：Compared with before treatment,after treatment,there were significant reductions in NIHSS score,levels of endothelin（ET）-1,CXCL16 and hsCRP,and significant rise in mean blood flow velocities of middle cerebral artery（MCA）and anterior cerebral artery（ACA）and nitric oxide（NO）level in two groups（P=0.001 all）;compared with routine treatment group after treatment,there were significant reductions in NIHSS[（9.78±3.59）scores vs.（7.02±3.67）scores],levels of ET-1 [（75.75±10.67）pg/ml vs.（62.56±9.45）pg/ml],CXCL16[（2.01±0.84）ng/ml vs.（1.67±0.75）ng/ml]and hsCRP[（4.42±1.66）mg/L vs.（3.89±1.37）mg/L],and significant rise in mean blood flow velocities of MCA [（48.87±5.23）cm/s vs.（55.35±6.35）cm/s]and ACA [（41.25±4.89）cm/s vs.（47.88±5.47）cm/s]and NO level[（55.77±6.36）μmol/L vs.（65.76±6.86）μmol/L]in argatroban group,P〈0.05 or〈0.01.There was no significant difference in incidence rate of hemorrhage events between two groups（P=0.315）.Conclusion：Argatroban based on routine treatment can more effectively improve cerebral blood flow and vascular endothelial function,reduce levels of CXCL 16 and hsCRP,and improve clinical therapeutic effect.