阿加曲班对陈旧性椎基底动脉系统脑梗死后头晕的临床疗效与安全性

Clinical efficacy and safety of argatroban in treating dizziness after old vertebra-basilar artery system infarction

目的观察阿加曲班对陈旧性椎基底动脉系统脑梗死患者头晕症状的治疗效果及安全性。方法回顾性选择2022年5月—2022年11月于天津市人民医院急诊就诊主诉为头晕的既往存在椎基底动脉系统脑梗死患者102例,根据治疗方案将患者分为对照组(n=50)和试验组(n=52)。对照组患者急诊就诊后均接受常规治疗,包括对症止晕、减轻胃肠道反应、纠正水电解质紊乱等,给予降压、降糖及改善脑循环代谢等治疗。试验组在对照组基础上加用阿加曲班注射液,每天10 mg加入0.9%氯化钠注射液100 mL,3 h内静脉滴注,连续治疗5 d。两组患者于就诊时及治疗第5天分别进行眩晕障碍量表(DHI)评分,根据DHI评分进行疗效判定,并观察出血并发症发生情况。结果试验组总有效率为96.15%,显著高于对照组的74.00%(P<0.05);试验组显效率为88.46%,显著高于对照组的62.00%(P<0.05)。就诊时,两组患者DHI评分比较,差异无统计学意义(P>0.05)。在治疗第5天,两组DHI评分均显著低于同组就诊时水平(P<0.05);且试验组DHI评分显著低于对照组(P<0.05)。治疗期间,两组各有2例患者出现晚间刷牙时牙龈出血,无严重出血情况发生。结论阿加曲班联合常规治疗手段对陈旧性椎基底动脉系统脑梗死后头晕症状具有明显改善作用,且效果优于常规治疗;起效迅速且不增加出血事件发生率。

Objective To observe the therapeutic effect and safety of argatroban on dizziness symptoms in patients with old vertebrabasilar artery system infarction.Methods A retrospective study was conducted to select 102 patients with vertebra-basilar system cerebral infarction who were admitted to the Department of Emergency of Tianjin Union Medical Center from May 2022 to November 2022 and complained of dizziness.According to the treatment plan,the patients were divided into the control group(n=50)and the experimental group(n=52).Patients in the control group received routine treatment after emergency treatment,including symptomatic dizziness control,reduction of gastrointestinal reactions,correction of water and electrolyte disorders,and treatment of hypertension,hypoglycemia,and improvement of cerebral circulation and metabolism.On the basis of the control group,patients in the experimental group were supplemented with Argatroban Injection,with 10 mg added to 100 mL of 0.9%Sodium Chloride Injection,intravenous infusion was performed within three hours for five consecutive days.Patients in two groups were scored with the Dizziness Handicap Inventory(DHI)at the time of treatment and on the 5th day of treatment.The efficacy was evaluated based on the DHI score,and the occurrence of bleeding complications was observed.Results The total effective rate of the experimental group was 96.15%,significantly higher than 74.00%of the control group(P<0.05).The apparent efficiency of the experimental group was 88.46%,significantly higher than the 62.00%of the control group(P<0.05).At the time of treatment,there was no statistically significant difference in DHI scores between the two groups(P>0.05).On the 5th day of treatment,the DHI scores of both groups were significantly lower than the level at the same group's visit(P<0.05).And the DHI score of the experimental group was significantly lower than that of the control group(P<0.05).During the treatment period,two patients in each group experienced gum bleeding during evening brushing,with no severe bleeding observed.Conclusion Argatroban combined with conventional treatment has a significant improvement effect on dizziness symptoms after old vertebra-basilar artery system infarction,and the effect is superior to conventional treatment.It takes effect quickly and does not increase the incidence of bleeding events.