阿加曲班联合阿司匹林用于急性脑梗死患者的临床效果

Clinical effect of argatroban combined with aspirin in patients with acute cerebral infarction

目的探讨阿加曲班联合阿司匹林对急性脑梗死血液流变学、神经功能及血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)、甲壳质酶蛋白40(YKL⁃40)的影响。方法选取2020年1月至2023年3月河北省保定市第二中心医院诊治的124例急性脑梗死患者作为研究对象,按照随机数字表法分为观察组(予以阿加曲班联合阿司匹林治疗)与对照组(予以阿司匹林治疗)各62例,对比治疗前和治疗14 d后的血液流变学参数、NIHSS评分、mRS评分、CRP、Hcy、YKL⁃40、血栓弹力图参数及不良反应。结果两组治疗后全血低切黏度、全血高切黏度、血浆黏度、红细胞比容均低于治疗前,且观察组低于对照组,差异有统计学意义(t=3.988、8.355、6.380、3.844,P<0.05)。两组治疗后NIHSS、mRS评分均低于治疗前,且观察组低于对照组,差异有统计意义(t=11.184、27.657,P<0.05)。两组治疗后血清CRP、Hcy、YKL⁃40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(t=6.163、8.240、6.134,P<0.05)。两组治疗后α角、MA均低于治疗前,且观察组低于对照组,而R、K均高于治疗前,观察组高于对照组,差异有统计学意义(t=2.735、2.663、2.454、2.661,P<0.05)。观察组不良反应发生率与对照组比较,差异无统计学意义(χ^(2)=0.152,P=0.697>0.05)。结论阿加曲班联合阿司匹林治疗急性脑梗死效果显著,不仅能改善血液流变学和神经功能,并且能降低血清CRP、Hcy、YKL⁃40表达。

Objective To investigate the effect of argatroban combined with aspirin on blood rheology,neurological function and serum C⁃reactive protein(CRP),homocysteine(Hcy),and chitinase protein 40(YKL⁃40)in acute cerebral infarction.Methods One hundred and twenty⁃four patients with acute cerebral infarction treated in the Second Central Hospital of Baoding,Hebei Province from January 2020 to March 2023 were selected as the study subjects and were divided into the observation group(treated with argatroban combined with aspirin)and the control group(treated with aspirin)according to the random number table method,62 cases in each group.The hemorheology parameters,NIHSS score,mRS score,CRP,Hcy,YKL⁃40,thromboelastography parameters and adverse reactions were compared before treatment and after 14 days of treatment.Results The whole blood low⁃cut viscosity,whole blood high⁃cut viscosity,plasma viscosity,and erythrocyte specific volume were lower in both groups after treatment than before treatment,and the observation group was lower than the control group(t=3.988,8.355,6.380,3.844,P<0.05).The NIHSS and mRS scores were lower than those before treatment in both groups,and the observation group was lower than the control group(t=11.184,27.657,P<0.05).The serum CRP,Hcy and YKL⁃40 levels were lower than those before treatment in both groups after treatment,and the observation group was lower than the control group(t=6.163,8.240,6.134,P<0.05).Theαangle and MA were lower than before treatment in both groups,and lower in the observation group than in the control group,while R and K were higher than before treatment,and higher in the observation group than in the control group(t=2.735,2.663,2.454,2.661,P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(χ^(2)=0.152,P=0.697>0.05).Conclusion Argatroban combined with aspirin has a significant effect in the treatment of acute cerebral infarction.It can not only improve hemorheology and neurological function,but also reduce the expression of serum CRP,Hcy and YKL⁃40.