阿加曲班对后循环梗死患者脑血流动力学的影响

Effect of argatroban on cerebral hemodynamics in patients with posterior circulation infarction

目的观察阿加曲班对后循环梗死患者脑血流动力学的影响。方法回顾性分析2014年1月至2018年7月在泰州市中医院脑病科住院的80例后循环梗死患者临床资料,按治疗方法不同分为对照组和阿加曲班组各40例。对照组采用抗血小板聚集、降脂、稳定斑块、调控血压、改善循环治疗。阿加曲班组在对照组治疗基础上加用阿加曲班联合治疗。比较2组治疗前和治疗后14 d患者的左右椎动脉、基底动脉在收缩期峰值血流速度(Vs)、舒张期血流速度(Vd)及平均血流速度(Vm),采用美国国立卫生研究院卒中量表(NIHSS)对治疗前和治疗14 d后患者的神经功能缺损评分进行对比,分析2组治疗28 d后的临床疗效。结果治疗14 d后阿加曲班组患者的脑血流动力学较对照组明显改善(P<0.05),治疗14 d后阿加曲班组患者的NIHSS评分较对照组明显下降([10.33±3.41)分vs(12.33±3.53)分,P<0.05]。治疗28 d后阿加曲班组较对照组临床有效率明显提高(80.00%vs 57.50%,P<0.05)。结论阿加曲班能改善后循环梗死患者脑血流动力学,改善神经功能障碍,在临床值得推广。

Objective To observe the effect of agatraban on cerebral hemodynamics in patients with posterior circulation in farction.Methods The clinical data of 80 patients with posterior circulation infarction who were hospitalized in the Department of encephalopathy of Taizhou Hospital of traditional Chinese medicine from January 2014 to July 2018 were analyzed retrospectively.Ac cording to different treatment methods,they were divided into control group and agaquban group with 40 cases each.The control group was treated with antiplatelet aggregation,lipid-lowering,plaque stabilization,blood pressure regulation and circulation improvement.Agaquban group was treated with agaquban combined with agaquban on the basis of the control group.The peak systolic velocity(VS),diastolic velocity(VD)and mean velocity(VM)of left and right vertebral artery and basilar artery were compared before and 14 days after treatment.The NIHSS was used to compare the neurological deficit scores of the patients before and after treatment for 14 days,and the clinical effects of the two groups after treatment for 28 days were analyzed.Results After 14 days of treatment,thehe modynamics of the patients in agaquban group was significantly improved than that in the control group(P<0.05).After 14 days of treatment,the NIHSS score of the patients in agaquban group was significantly lower than that in the control group[(10.33±3.41)vs(12.33±3.53),P<0.05].After 28 days of treatment,the clinical effective rate of agatroban group was significantly higher than that of the control group(80.00%vs 57.50%,P<0.05).Conclusion Agatraban can improve cerebral hemodynamics and neurological dys function in patients with posterior circulation infarction,which is worth popularizing in clinic.