阿加曲班联合阿司匹林序贯治疗对进展性脑卒中的疗效观察

Effect of sequential treatment of argatroban combined with aspirin on progressive stroke

目的观察阿加曲班注射液联合阿司匹林肠溶片序贯治疗对进展性脑卒中的疗效。方法选取2019年1月1日—2021年4月1日重庆市巴南区第二人民医院神经内科收治的91例进展性脑卒中患者为研究对象,进行回顾性研究。根据治疗方法将患者分为对照组(n=54)和观察组(n=37)。两组患者均予以改善循环、稳定斑块等常规治疗;对照组给予阿司匹林肠溶片100 mg/次,1次/d;观察组予以阿加曲班注射液60 mg/次,1次/d,24 h持续静脉泵入,第3~7天改为10 mg/次,2次/d,静脉滴注,7 d后予以阿司匹林肠溶片100 mg/次,1次/d,两组均治疗14 d。观察两组患者的临床疗效,比较两组患者治疗后及出院后3个月美国国立卫生研究院脑卒中(NIHSS)量表评分及改良Rankin量表(mRS)评分,并观察出血、神经功能恶化、过敏等不良事件发生情况。结果两组治疗14 d后,观察组总有效率为81.08%,显著高于对照组的57.41%(P<0.05)。治疗14 d后,观察组NIHSS评分较对照组显著降低(P<0.05);出院3个月后观察组NIHSS评分也显著低于对照组(P<0.05),且mRS评分较对照组显著降低(P<0.05)。观察组和对照组的总药物不良反应发生率分别为8.1%和9.2%,差异无统计学意义(P>0.05)。结论阿加曲班注射液联合阿司匹林肠溶片序贯治疗能减轻进展性脑卒中患者的神经功能缺损,并能有效改善3个月后的日常独立生活能力,且不增加出血等不良事件的发生率。

Objective To investigate the therapeutic effect of sequential treatment of Argatroban Injection combined with aspirin on progressive stroke.Methods a retrospective study was conducted on 91 patients with progressive stroke treated in the Department of Neurology of the Second People's Hospital of Banan District,Chongqing from January 1,2019 to April 1,2021.According to the treatment methods,the patients were divided into control group(n=54)and experimental group(n=37).Patients in both groups were given routine treatment such as improving circulation and stabilizing plaque.Patients in the control group was given Aspirin Enteric Coated Tablets 100 mg/time,once a day.Patients in the experimental group were given Argatroban Injection 60 mg/time,once a day,continuously pumped intravenously for 24 h,changed to 10 mg/time,twice a day,intravenously on the 3rd—7th day,and Aspirin Enteric Coated Tablets 100 mg/time,once a day after seven days.Patients in both groups were treated for 14 days.The clinical efficacy of the two groups was observed.The scores of NIHSS and mRS were compared between the two groups after treatment and three months after discharge,and the incidence of adverse events such as bleeding,deterioration of neurological function and allergy were observed.Results After 14 days of treatment,the total effective rate in the observation group was 81.08%,which was significantly higher than 57.41%in the control group(P<0.05).After 14 days of treatment,the NIHSS score in the experimental group was significantly lower than that in the control group(P<0.05).Three months after discharge,the NIHSS score of the experimental group was also significantly lower than that of the control group(P<0.05),and the mRS score was significantly lower than that of the control group(P<0.05).The total incidence of adverse drug reactions in the experimental group and the control group were 8.1%and 9.2%respectively,with no significant difference(P>0.05).Conclusion The sequential treatment of Argatroban Injection combined with Aspirin Enteric Coated Tablets can reduce the neurological deficit of patients with progressive stroke,effectively improve the ability of independent daily living after three months,and does not increase the incidence of adverse events such as bleeding.