阿加曲班不同给药方式超早期治疗急性缺血性脑卒中的疗效及安全性观察

Observation on efficacy and safety of different administration methods of argatroban in ultra early treatment of acute ischemic stroke

目的探索阿加曲班不同给药方式对超早期急性缺血性脑卒中患者的疗效及安全性。方法回顾性选取2019年2月—2020年11月在肇庆市第一人民医院神经内科住院的急性缺血性脑卒中患者64例为研究对象,根据给药方式不同将患者分为静脉滴注组(静滴组)和微泵+静脉滴注组(微泵+静滴组),静滴组患者给予阿加曲班注射液,10 mg阿加曲班注射液加入0.9%氯化钠注射液250 mL中,静脉滴注给药,每天2次,连续给药(7±1)d;微泵+静滴组患者给予阿加曲班注射液,持续微泵(10 mL·h^(-1))24 h或者48 h,其后采用10 mg阿加曲班注射液加入0.9%氯化钠注射液250 mL中,静脉滴注给药,每天2次,连续给药(5±2)d。比较两组患者临床治疗效果及不良反应。结果静滴组总有效率(55.88%)高于微泵+静滴组(53.55%),但差异无统计学意义(P>0.05)。两组患者出院时美国国立卫生研究院卒中量表(NIHSS)评分均低于本组入院时NIHSS评分(P<0.05),两组间出院时NIHSS评分比较,差异无统计学意义(P>0.05)。两组患者出院时改良Rankin量表(MRS)≤1分的患者占比比较,差异有统计学意义(P<0.05),静滴组占比更高。两组患者出院时MRS评分≤2分的患者占比比较,差异无统计学意义(P>0.05)。两组均未发生出血事件及新发心脑血管事件。结论阿加曲班静脉滴注给药治疗急性缺血性脑卒中的疗效显著,安全性高。

Objective To explore efficacy and safety of different administration methods of argatroban in patients with ultra early acute ischemic stroke.Method A retrospective study was conducted on 64 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at the First People's Hospital of Zhaoqing City from February 2019 to November 2020.The patients were divided into an intravenous drip group(intravenous drip group)and a micropump+intravenous drip group(micropump+intravenous drip group)based on different administration methods.The intravenous drip group received Argatroban Injection,with 10 mg of Argatroban Injection added to 250 mL of 0.9%Sodium Chloride Injection,intravenous drip administration,twice a day,continuous for(7±1)days.The patients in the micropump+intravenous drip group were given Argatroban Injection for 24 or 48 hours with a continuous micropump(10 mL·h^(-1)).Afterwards,10 mg Argatroban Injection was added to 250 mL of 0.9%Sodium Chloride Injection,and administered intravenously twice a day for a continuous period of(5±2)days.Compare the clinical treatment efficacy and adverse reactions between two groups of patients.Results The total effective rate of the intravenous drip group(55.88%)was higher than that of the micropump+intravenous drip group(53.55%),but the difference was not statistically significant(P>0.05).The National Institutes of Health Stroke Scale(NIHSS)scores at discharge for both groups of patients were lower than the NIHSS scores at admission for this group(P<0.05),and there was no statistically significant difference in NIHSS scores at discharge between the two groups(P>0.05).There was a statistically significant difference in the proportion of patients with a Modified Rankin Scale(MRS)score of≤1 between the two groups at discharge(P<0.05).There was no statistically significant difference in the proportion of patients with MRS scores≤2 when discharged between the two groups(P>0.05).There were no bleeding events or new cardiovascular or cerebrovascular events in both groups.Conclusion Argatroban intravenous infusion has a significant therapeutic effect and high safety in the treatment of acute ischemic stroke.