阿加曲班治疗穿支动脉梗死溶栓后神经功能恶化33例

Argatroban in 33 Patients with Neurological Deterioration after Thrombolysis of Perforating Artery Infarction

目的:探讨阿加曲班对穿支动脉梗死溶栓后神经功能恶化患者疗效及安全性。方法:选择2019年6月至2021年4月宜春市第二人民医院收治的穿支动脉梗死溶栓后神经功能恶化患者66例,采用随机数字表法分为两组,各33例。对照组采用氯吡格雷+安慰剂治疗,观察组采用阿加曲班+氯吡格雷治疗,连续治疗2周。比较两组神经功能评分、日常生活能力、凝血功能及药物安全性。结果:治疗后两组活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)对比,差异无统计学意义(P>0.05);观察组治疗后神经功能、日常生活能力评分均低于对照组,血浆纤维蛋白原(FIB)高于对照组,差异有统计学意义(P<0.05)。结论:在穿支动脉梗死溶栓后神经功能恶化患者中采用阿加曲班治疗,利于改善神经功能,增强日常生活能力,且不会增加不良反应,临床应用安全可靠。

Objective:To investigate the efficacy and safety of argatroban on patients with neurological deterioration after thrombolysis of perforating artery infarction.Methods:From June 2019 to April 2021,66 patients with neurological deterioration after thrombolysis of perforating artery infarction were selected and divided into two groups by random number table method,with 33 cases in each group.The control group was treated with clopidogrel plus placebo,and the observation group was treated with argatroban plus clopidogrel for two consecutive weeks.The scores of neurological function,ability of daily living,blood coagulation function and drug safety were compared between the two groups.Results:After treatment,the difference between the two groups of activated partial thromboplastin time(APTT)and plasma prothrombin time(PT)was not statistically significant(P>0.05).The scores of neurological function and ability of daily living in the observation group were lower than those of the control group,and plasma fibrinogen(FIB)was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Argatroban treatment in patients with deterioration of nerve function after thrombolysis of perforating artery infarction is beneficial to improve nerve function and enhance the ability of daily living without increasing adverse reactions.It is safe and reliable in clinical application.