阿加曲班联合双联抗血小板治疗轻型缺血性卒中的有效性及安全性观察

Efficacy and safety of argatroban combined with dual antiplatelet therapy in the treatment of mild ischemic stroke

目的观察阿加曲班联合双联抗血小板治疗轻型缺血性脑卒中的临床疗效和安全性。方法本研究将轻型缺血性脑卒中患者96例随机分为阿加曲班治疗试验组(48例)和对照组(48例),观察两组用药后14d后NIHSS评分、1月mRS评分和评分值0~1分与1~2分两组患者比例,同时观察两组不良事件发生率。结果试验组14d后NIHSS评分值为(1.75±0.51)分,对照组为(2.23±0.82)分,试验组NIHSS评分显著低于对照组,差异有统计学意义(P<0.05)。试验组1月后mRS评分值为(0.56±0.61)分,对照组为(0.82±0.84)分,两组相比差异无统计学意义(P=0.086)。试验组评分值0~1分患者人数为28例(58.3%),1~2分患者人数为20例(41.7%),对照组0~1分患者人数为17例(35.4%),1~2分患者人数为31例(64.6%),试验组相较于对照组的OR值为2.553,差异有统计学意义(P=0.025)。两组均无症状性颅内出血情况发生,差异无统计学意义(P>0.05)。试验组脑梗死复发显著低于对照组,差异有统计学意义(P<0.05)。结论阿加曲班联合双联抗血小板治疗轻型缺血性卒中能够改善患者神经功能,防止梗死再复发,安全性高。

Objective To observe the clinical efficacy and safety of argatroban combined with dual antiplatelet therapy in the treatment of mild ischemic stroke.Methods 96 patients with mild ischemic stroke were randomly divided into the argatroban treatment group(n=48)and the control group(n=48).The NIHSS and mRS scores at 14 days,1 month and 0~1,1~2 scores of the two groups were observed,and the incidence of adverse events was observed.Results The NIHSS score at the 14 days of the experimental group was(1.75±51),compared with(2.23±0.82),respectively.The NIHSS score of the experimental group was significantly lower than that of the control group(P<0.05).One month later,mRS score of the experimental group was(0.56±61),(0.82±84)in the control group,there was no significant difference between the two groups(P=0.086).The number of patients with 0~1 score in the experimental group was 28(58.3%),the number of patients with 1~2 score was 20(41.7%),the number of patients with 0~1 score in the control group was 17(35.4%),the number of patients with 1~2 score was 31(64.6%),the OR value of the experimental group was 2.553 compared with the control group,the difference was statistically significant(P=0.025).There was no significant difference in asymptomatic intracranial hemorrhage between the experimental group and the control group(P>0.05).The recurrence of cerebral infarction in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Argatroban combined with dual antiplatelet therapy in the treatment of mild ischemic stroke can help to improve the neurological function and prevent the recurrence of infarction,with high safety.