阿加曲班、丁苯酞、阿司匹林联合治疗进展性缺血性脑卒中临床疗效观察

Observation on clinical efficacy of combined use of argatroban,butyphthalide and aspirin in treating progressive ischemic-stroke

目的评估阿加曲班、丁苯酞、阿司匹林联合治疗进展性缺血性脑卒中(PIS)的临床疗效及安全性。方法选取2016年1月至2019年1月就诊于该院神经内科的235例急性缺血性脑卒中患者中诊断为PIS患者86例,根据治疗方案不同分为观察组和对照组,每组43例。2组均给予静脉滴注丁苯酞和口服阿司匹林治疗,观察组同时给予阿加曲班治疗。评估2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)评分,以及C反应蛋白、D-二聚体水平等。结果2组患者治疗前NIHSS、BI评分,C反应蛋白、D-二聚体水平,治疗后7 d D-二聚体水平比较,差异均无统计学意义(P>0.05);2组患者治疗后24 h,7、14 d NIHSS、BI评分,治疗后7、14 d C反应蛋白水平,治疗后14 d D-二聚体水平比较,差异均有统计学意义(P<0.05);观察组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。2组患者治疗过程中均未发生不良反应。结论阿加曲班、丁苯酞、阿司匹林联合治疗PIS能明显改善患者神经功能缺损状态,抑制炎症的发生,提高患者日常生活能力并改善其预后,且用药安全性较好。

Objective To evaluate the clinical efficacy and safety of combined use of argatroban,butyphthalide and aspirin in the treatment of progressive ischemic-stroke(PIS).Methods Among 235 patients with acute ischemic stroke admitted to the department of neurology of the hospital from January 2016 to January 2019,86 cases were diagnosed as PIS and divided into the control group and observation group according to the treatment regimen,43 cases In each group.The two groups were given intravenous dripping of butyphthalide and oral aspirin,while the observation group was simultaneously given argatroban treatment.The national institutes of health stroke scale(NHISS)score,Barthel index(BI)scores and the levels of CRP and D-dimer before and after treatment were observed in the two groups.Results The NIHSS score,BI index and levels of CRP and D-dimer before treatment and D-dimer level after 7 d treatment had no statistical differences between the two groups(P>0.05).The NIHSS and Barthel scores at postoperative 24 h,on postoperative 7,14 d,CRP level on postoperative 7,14 d and D-dimer level on postoperative 14 d had statistical differences between the two groups(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group with statistical difference(P<0.05).No adverse reactions occurred in the two groups during the treatment process.Conclusion The combined use of argatroban,butyphthalide and aspirin in the treatment of PIS can significant improve the neurological impairment status of the patients,inhibit the inflammation occurrence,increase their daily living ability,improve their prognosis,moreover the medication has good safety.