阿加曲班联合丁苯酞治疗进展性脑梗死患者的效果

Effects of Argatroban combined with Butylphthalide in treatment of patients with progressive ischemic stroke

目的:观察阿加曲班联合丁苯酞治疗进展性脑梗死患者的效果。方法:回顾性分析2020年1月至2022年1月该院收治的90例进展性脑梗死患者的临床资料,按治疗方案不同将其分为对照组42例和观察组48例。两组均给予常规治疗,在此基础上,对照组采用丁苯酞治疗,观察组在对照组基础上联合阿加曲班治疗。比较两组临床疗效、治疗前后神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、血液流变学指标(全血高切黏度、全血低切黏度)水平、凝血功能指标[D-二聚体(D-D)、纤维蛋白原(FIB)]水平,以及不良反应发生率。结果:治疗7、14 d后,两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为95.83%(46/48),高于对照组的78.57%(33/42),差异有统计学意义(P<0.05);治疗7 d后,两组全血高切黏度、全血低切黏度、FIB、D-D水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿加曲班联合丁苯酞治疗进展性脑梗死患者可提高治疗总有效率,降低NIHSS评分,改善血液流变学指标和凝血功能指标水平,效果优于单纯丁苯酞治疗。

Objective: To observe effects of Argatroban combined with Butylphthalide in treatment of patients with progressive ischemic stroke. Methods: The clinical data of 90 patients with progressive ischemic stroke admitted to this hospital from January 2020 to January 2022were retrospectively analyzed. They were divided into control group(42 cases) and observation group(48 cases) according to different treatment schemes. Both groups were given routine treatment. On this basis, the control group was treated with Butylphthalide, while the observation group was treated with Argatroban on the basis of that of the control group. The clinical efficacy, the neurological deficit [National Institutes of Health stroke scale(NIHSS)] score, the hemorheology index levels(whole blood high shear viscosity, whole blood low shear viscosity), the coagulation function index levels [D-dimer(D-D), fibrinogen(FIB)], and the incidence of adverse reactions were compared between the two groups before and after the treatment. Results: After 7 and 14 days of treatment, the NIHSS scores of the two groups were lower than those before treatment, that of the observation group was lower than that of the control group, and the differences were statistically significant(P<0.05). The total effective rate of treatment in the observation group was 95.83%(46/48), which was higher than 78.57%(33/42) in the control group, and the difference was statistically significant(P<0.05). After 7 days of treatment, the levels of whole blood high shear viscosity, whole blood low shear viscosity, FIB and D-D in the two groups were lower than those before treatment, those in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: Argatroban combined with Butylphthalide in the treatment of the patients with progressive ischemic stroke can improve the total effective rate of treatment, and reduce the NIHSS score, hemorheology index levels and coagulation function index levels. Moreover, it is superior to single Butylphthalide treatment.