阿替普酶联合阿加曲班治疗急性脑梗死患者的临床疗效观察

Clinical Observation of rt-PA Combined with Argatroban in Patients with Acute Cerebral Infarction

目的:观察急性脑梗死患者接受阿替普酶(rt-PA)静脉溶栓+阿加曲班治疗后神经功能及生活能力的改善情况。方法:选取急性脑梗死患者108例,研究组50例患者接受静脉溶栓后给予阿加曲班治疗+常规治疗(抗血小板、强化他汀、活血化瘀);对照组58例静脉溶栓后给予常规治疗。分别在发病1周、1个月、3个月进行NIHSS评分、Barthel指数评分。比较两组患者的神经功能及自主生活能力恢复情况。结果:治疗1周时,研究组与对照组的NIHSS评分有统计学差异(P=0.001),Barthel指数评分无统计学差异(P=1.560)。治疗1个月时,研究组与对照组的NIHSS评分和Barthel指数评分均有统计学差异(P=0.008;P=0.000)。治疗3个月时,研究组与对照组的NIHSS评分无统计学差异(P=0.062),Barthel指数评分有统计学差异(P=0.000)。结论:静脉溶栓后给予阿加曲班治疗对急性脑梗死患者的早期生活质量改善和神经功能恢复有一定积极意义。

Objective:To observe the improvement of neural function and ability of daily life in patients with acute cerebral infarction after intravenous thrombolysis with rt-PA combined with argatroban.Methods:108 patients with acute cerebral infarction were included in the current study,among which 50 patients(study group)were given argatroban plus conventional treatment(anti-platelet,enhanced statins,activating blood circulation and removing blood stasis)after intravenous thrombolysis,and 58 patients(control group)were given conventional treatment after intravenous thrombolysis.NIHSS score and Barthel index score were collected at 1 week,1 month and 3 months,respectively.The recovery of neural function and autonomic living ability in the two groups were compared.Results:At 1 week after treatment,the NIHSS scores of the study group and the control group were significantly different(P=0.001).At 1 month,statistic difference was also observed in NIHSS score and Barthel score between the two groups(P=0.008,P=0.000).At 3 months,the two groups were found obviously different in their Barthel scores(P=0.000),while the difference in NIHSS score held no statistic difference.Conclusion:The treatment of argatroban after intravenous thrombolysis in patients with acute cerebral infarction has certain positive impact on the early life quality and neural function recovery.