阿加曲班治疗频发短暂性脑缺血发作的疗效观察

Clinical observation of argatroban in treatment of frequent transient ischemic attack

目的观察阿加曲班治疗频发短暂性脑缺血发作的疗效。方法选取2019年1月-2021年1月在天津市宁河区医院治疗的68例频发短暂性脑缺血发作患者,随机分为对照组(34例)和治疗组(34例)。对照组静脉滴注注射用血塞通,400 mg加入生理盐水500 mL,1次/d,每次滴注时间>3 h。治疗组静脉滴注阿加曲班注射液,60 mg溶入生理盐水500 mL持续滴注24 h,连续2 d,此后5 d以10 mg加入生理盐水250 mL滴注,2次/d,每次滴注时间>3 h,2次间隔>8 h。两组治疗7 d。观察两组患者临床疗效,比较治疗前后两组患者脑梗死转化和神经功能评分。结果治疗后,治疗组总有效率为97.1%。明显高于对照组的79.4%(P<0.05)。治疗后,治疗组脑梗死转化率为11.8%,明显低于对照组的41.2%(P<0.05)。治疗后,治疗组美国国立卫生研究院卒中量表(NIHSS)评分和90 d改良Rankin残疾量表(m RS)评分明显低于对照组(P<0.05)。结论阿加曲班可有效、安全控制频发短暂性脑缺血发作,降低其脑梗死转化率,具有一定临床推广应用价值。

Objective To observe the efficacy of argatroban in treatment of frequent transient ischemic attack. Methods Patients(68 cases) with requent transient ischemic attack in Ninghe Hospital from January 2019 to January 2021 were randomly divided into control(34 cases) and treatment(34 cases) groups. Patients in the control group were iv administered with Xuesaitong for injection, 400 mg added into normal saline 500 mL and continuously dropped for more 3 h, once daily. Patients in the treatment group were iv administered with Argatroban Injection, 60 mg added into normal saline 500 mL for 24 h, and they were treated for 2 d, then dropped with 10 mg added into normal saline 250 mL for 5 d, twice daily, the time of each infusion more than 3 h, and the interval time was more 8 h.Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, the cerebral infarction transformation and neurological function scores in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.1%, which was significantly higher than 79.4% in the control group(P < 0.05). After treatment, the conversion rate of cerebral infarction in the treatment group was 11.8%, which was significantly lower than 41.2% in the control group(P < 0.05). After treatment, the scores of NIHSS and mRS in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Argatroban can effectively and safely control frequent transient ischemic attacks and reduce the conversion rate of cerebral infarction, which has a certain clinical application value.