阿加曲班治疗发病6小时以上老年急性脑梗死的安全性及有效性

Safety and efficacy of argatroban on elderly patients with acute cerebral infarction over 6 hours after onset

目的 研究阿加曲班治疗发病6 h以上老年急性脑梗死患者的安全性及有效性.方法 选取2016年8月至2017年10月临汾市人民医院收治的发病6 h以上老年急性脑梗死患者98例,采用随机化列表将其分为对照组和治疗组,每组49例.对照组采用临床常规治疗,治疗组在对照组治疗基础上加用阿加曲班.观察比较两组治疗前及用药后14 d的美国国立卫生研究院卒中量表（NIHSS）评分、日常生活活动（ADL）评分、不良反应和治疗效果.结果 对照组总有效率（77.55％）低于治疗组（91.83％）,差异有统计学意义（P〈0.05）;对照组治疗后14 d神经功能缺损程度NIHSS评分（6.27±3.12）高于治疗组（3.87±2.62）,差异有统计学意义（P〈0.05）;对照组治疗后14 d ADL评分（40.17±7.75）高于治疗组（36.25±8.48）,差异有统计学意义（P〈0.05）.治疗组血常规和凝血系列均在合理的范围内,未出现出血、胃肠道不良反应.结论 阿加曲班治疗发病6h以上老年急性脑梗死患者安全、有效,能提高临床疗效,改善NIHSS和ADL的评分,且不良反应少.

Objective To study the safety and efficacy of argatroban on elderly patients with acute cerebral infarction over 6 hours after onset .Methods Ninety-eight patients with acute cerebral infarction over 6 hours from August 2016 to October 2017 in Linfen People ＇ s Hospital were selected and were divided into control group and treatment group by randomization list , with 49 cases in each group . Patients in control group were treated by clinical routine treatment .Patients in treatment group were treated with argatroban on the basis of treatment for control group .The National Institute of Health stroke scale （ NIHSS） score, activity of daily living （ ADL） score, adverse reactions and therapeutic effect before treatment and after 14 days of treatment were compared between the two groups .Results The total effective rate of control group （ 77.55%） was lower than that of treatment group （ 91.83%） , the difference was statistically significant （P〈0.05）.The NIHSS score of control group （6.27 ±3.12） was significantly higher than that of treatment group （ 3.87 ±2.62 ） after 14 days of treatment , and the difference was statistically significant （P〈0.05）.The ADL score of control group （40.17 ±7.75） was significantly higher than that of treatment group （ 36.25 ±8.48 ） after 14 days of treatment , and the difference was statistically significant （ P〈0.05） .The blood routine and coagulation status in treatment group were in a reasonable range , and no bleeding or gastrointestinal tract adverse reaction was found . Conclusions Argatroban in the treatment of elderly patients with acute cerebral infarction with over 6 hours after onset is safe and effective .It can improve the clinical efficacy , NIHSS score and ADL score , with fewer adverse reactions .