阿加曲班联合阿司匹林治疗前循环急性进展性脑梗死的疗效探讨

Exploring the Efficacy of Argatroban Combined with Aspirin in the Treatment of Acute Progressive Cerebral Infarction in the Anterior Circulation

目的探讨对前循环急性进展性脑梗死予阿加曲班联合阿司匹林治疗的临床效果。方法选择2020年1月—2021年12月南京鼓楼医院集团仪征医院收治的前循环急性进展性脑梗死患者85例,根据治疗方案不同分为阿司匹林治疗对照组(n=41)与阿加曲班联合阿司匹林治疗观察组(n=44),比较两组临床疗效,于治疗前后采用神经功能缺损评分(NIHSS)、改良Rankin量表(mRS)评估患者神经功能,并采用巴氏指数(Bar⁃thel)评估患者生活能力。结果观察组总有效率较对照组高(95.45%vs 78.05%),差异有统计学意义(χ^(2)=5.707,P<0.05);治疗后观察组NIHSS评分(6.27±1.85)分、mRS评分(1.38±0.35)分均小于对照组,差异有统计学意义(t=7.420、5.365,P<0.05);治疗后14、30、90 d观察组患者Barthel评分(77.36±15.02)分、(84.42±14.36)分、(91.29±11.52)分均高于对照组,差异有统计学意义(t=2.157、2.203、2.254,P<0.05)。结论对前循环急性进展性脑梗死者采用阿加曲班联合阿司匹林治疗有利于病情控制,能提高患者神经功能及生活能力。

Objective To investigate the clinical effect of argatroban combined with aspirin in acute progressive cerebral infarction in the anterior circulation.Methods 85 cases of acute progressive cerebral infarction in the anterior circulation admitted to Nanjing Gulou Hospital Group Yizheng Hospital from January 2020 to December 2021 were selected and divided into aspirin-treated control group(n=41)and augatroban combined with aspirin-treated observation group(n=44)according to different treatment regimens.The clinical efficacy of the two groups was compared,and the patients'neurological function was evaluated by the Neurological Impairment Score(NIHSS)and the Modified Rankin Scale(mRS)before and after treatment,and the patients'living ability was assessed by the Barthel Index(Barthel).Results The total effective rate of the observation group was higher than that of the control group(95.45%vs 78.05%),the difference was statistically significant(χ^(2)=5.707,P<0.05);the NIHSS score(6.27±1.85)points and mRS score(1.38±0.35)points of the observation group were smaller than those of the control group after treatment,the difference was statistically significant(t=7.420,5.365,P<0.05);the Barthel index of patients at 14 d,30 d,and 90 d after treatment were(77.36±15.02)points,(84.42±14.36)points,(91.29±11.52)points of observation group,all higher than the control group,the difference was statistically significant(t=2.157,2.203,2.254,P<0.05).Conclusion Treatment with argatroban combined with aspirin in patients with acute progressive cerebral infarction in the anterior circulation is beneficial for disease control and improves neurological function and living ability of patients.