阿加曲班联合吡拉西坦对急性缺血性卒中患者认知功能及肢体功能的影响

Effects of argatroban combined with piracetam on cognitive function and limb function in patients with acute ischemic stroke

目的探讨阿加曲班联合吡拉西坦对急性缺血性卒中患者认知功能、肢体功能的影响。方法回顾性选取邢台市第三医院于2021年12月—2022年7月收治住院的80例急性缺血性卒中患者为研究对象,根据治疗方法将患者分为对照组和试验组,两组各40例。两组患者均给予常规治疗,对照组在常规治疗基础上给予注射用吡拉西坦(注射用吡拉西坦8 g加入到5%氯化钠注射液250 mL中)静脉滴注,每天1次,疗程为14 d;试验组在对照组治疗的基础上加用阿加曲班注射液治疗,第1~2天60 mg阿加曲班注射液用0.9%氯化钠注射液稀释后持续输液泵输液48 h,第3~7天将10 mg阿加曲班注射液加入0.9%氯化钠注射液20 mL中持续输液泵输液持续3 h,每天2次,用药7 d,其余治疗方案同对照组。分别于治疗前及治疗后3、6个月对两组患者进行蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)、改良式肢体运动功能量表(Fugl-Meyer)以及日常生活能力量表(ADL)评分,同时记录两组的不良反应发生情况。结果治疗前两组患者MoCA、MMSE、Fugl-Meyer及ADL评分比较,差异均无统计学意义(P>0.05);治疗后3、6个月两组患者MoCA、MMSE、Fugl-Meyer及ADL评分均较同组治疗前显著提高(P<0.05),且试验组各项评分均显著高于对照组(P<0.05)。治疗期间两组患者不良反应事件发生率比较差异无统计学意义(P>0.05)。结论阿加曲班联合吡拉西坦治疗能显著改善急性缺血性卒中患者的认知功能以及肢体功能,在保证疗效的同时并未增加出血等不良反应发生风险。

Objective To investigate the effect of argatroban combined with piracetam on cognitive function and limb function in patients with acute ischemic stroke.Methods A total of 80 patients with acute ischemic stroke admitted to Xingtai Third Hospital from December 2021 to July 2022 were selected as the study subjects.According to the treatment methods,the patients were divided into control group and experimental group,with 40 patients in each group.Patients in both groups were treated with routine therapeutic drugs,while patients in the control group were given intravenous drip of Piracetam for Injection(8 g of Piracetam for Injection was added to 250 mL of 5%Sodium Chloride Injection)on the basis of routine treatment,once a day,for 14 days.On the basis of the treatment of the control group,patients in the experimental group were treated with Argatroban Injection.On the first to second days,60 mg of Argatroban Injection was diluted with 0.9%Sodium Chloride Injection and then continued infusion with infusion pump for 48 hours.On the third to seventh days,10 mg of Argatroban Injection was added into 20 mL of 0.9%Sodium Chloride Injection and continued infusion with infusion pump for three hours,twice a day,and the total course of treatment was seven days.The other treatment schemes were the same as the control group.The patients in the two groups were scored with the Montreal Cognitive Assessment Scale(MoCA),the Simple Mental State Examination Scale(MMSE),the Modified Limb Motor Function Scale(Fugl-Meyer)and the Activity of Daily Living Scale(ADL)before and three and six months after treatment,respectively,and the adverse reactions in the two groups were recorded.Results There was no significant difference in MoCA,MMSE,Fugl-Meyer and ADL scores between the two groups before treatment(P>0.05).Three and six months after treatment,the scores of MoCA,MMSE,Fugl-Meyer and ADL of patients in the two groups were significantly higher than those before treatment(P<0.05),and the scores in the experimental group were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups during treatment(P>0.05).Conclusion Argatroban combined with piracetam can significantly improve the cognitive function and limb function of patients with acute ischemic stroke,without increasing the risk of bleeding and other adverse reactions while ensuring the efficacy.