血管内取栓联合阿加曲班治疗急性脑梗死患者的临床疗效与安全性

Clinical Efficacy and Safety of Intravascular Thrombectomy Combined with Agatroban in the Treatment of Acute Cerebral Infarction Patients

目的评估分析血管内取栓联合阿加曲班治疗急性脑梗死的临床疗效与安全性。方法纳入2023年1月—2023年12月江南大学附属医院收治的70例前循环大血管闭塞急性脑梗死患者,将70例患者采用随机数字表法分为观察组和对照组,每组35例。对照组予以血管内取栓,观察组予以血管内取栓联合阿加曲班治疗。对比两组患者治疗1个周后的临床有效率(有效定义为NIHSS评分改善≥4分),治疗90 d的良好预后率(良好预后定义为mRS评分0~2分),治疗2周内颅内出血、脑梗死出血转化、死亡不良事件的发生率。结果比较治疗1周的临床疗效,观察组患者的治疗总有效率高于对照组(P<0.05);比较治疗90 d的良好预后率,观察组患者良好预后率高于对照组(P<0.05);比较治疗2周内不良事件的发生率,观察组与对照组比较无统计学差异(P>0.05)。结论相比血管内取栓及常规药物治疗,血管内取栓及常规药物治疗基础上联合阿加曲班治疗急性脑梗死临床有效率更高,患者短期预后更好,且并未明显增加颅内出血、脑梗死出血转化、死亡等不良事件的发生率,提示阿加曲班可更好促进血管内取栓治疗的临床疗效,安全性良好。

Objective To analyze the clinical efficacy and safety of intravascular thrombectomy combined with Agatroban in the treatment of acute cerebral infarction.Methods Seventy cases of acute cerebral infarction with anterior circulation large vessel occlusion admitted to the Affiliated Hospital of Jiangnan University from January 2023 to December 2023 were included,and all the included patients were divided into the observation group and the control group using randomized numerical table method,with 35 cases in each group.The control group was treated with endovascular thrombolysis,and the observation group was treated with endovascular thrombolysis combined with argatroban.The clinical efficacy rate(effective is defined as improvement of NIHSS score≥4 points),good prognosis rate(good prognosis is defined as mRS score 0-2 points),and the incidence of intracranial hemorrhage,hemorrhagic transformation of cerebral infarction,and fatal adverse events in the 2-week period were compared in the patients of the two groups after 1 week of treatment.Results For the clinical efficacy of 1 week of treatment,the total effective rate of treatment of patients in the observation group was higher than that of the control group(P<0.05);for the good prognosis rate of 90 d of treatment,the good prognosis rate of patients in the observation group was higher than that of the control group(P<0.05);for the incidence rate of adverse events within 2 weeks of treatment,there was no statistical difference between the observation group and the control group(P>0.05).Conclusions Compared with endovascular thrombolysis and conventional drug therapy,the combination of endovascular thrombolysis and conventional drug therapy with argatroban in the treatment of acute cerebral infarction has a higher clinical efficiency and better short-term prognosis of the patients,and it does not significantly increase the incidence of intracranial hemorrhage,hemorrhagic transformation of cerebral infarction,death and other adverse events,which indicated that argatroban can better enhance the clinical efficacy of endovascular thrombolysis,and the safety was good.