阿加曲班联合阿替普酶治疗急性颅内动脉重度狭窄缺血性卒中

Clinical study on the combination of intravenous anticoagulation with agatroban and ateplase in the treatment of acute severe intracranial arterial stenosis ischemic stroke

目的 探讨阿加曲班静脉抗凝联合阿替普酶治疗急性颅内动脉重度狭窄缺血性卒中的临床效果。方法 选择2022年1月至2023年2月诊治的166例急性颅内动脉重度狭窄缺血性卒中患者展开此次研究,随机(随机单双数法)分为对照组与观察组患者各83例。对照组行脱水、降脂、阿替普酶等常规治疗,观察组基于对照组联合阿加曲班静脉抗凝治疗。治疗4周后,比较两组临床疗效;比较治疗前及治疗2周、4周后的美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRs)评分及简式Fugl-Meyer肢体运动功能量表(FMA)评分;比较两组治疗期间的不良反应。结果 相较于对照组,观察组总有效率明显较高(P<0.05);治疗2周、4周后,相较于对照组,观察组NIHSS、m Rs评分明显较低(P<0.05);治疗2周、4周后,相较于对照组,观察组FMA评分明显较高(P<0.05);在干预过程中,两组均未见皮肤出血、脑出血、恶心呕吐、牙龈出血等不良反应。结论 阿加曲班静脉抗凝联合阿替普酶治疗急性颅内动脉重度狭窄缺血性卒中的临床效果显著,能显著改善患者神经功能、运动功能,且安全性高,值得推广应用。

Objective To explore the clinical effect of intravenous anticoagulation with Agatroban combined with Ateplase in the treatment of severe acute intracranial arterial stenosis ischemic stroke.Methods A total of 166 patients with severe acute intracranial artery stenosis and ischemic stroke who were treated in the hospital from January 2022 to February 2023 were selected in this study.They were randomly(Random odd and even number method) divided into a control group and an observation group,with 83 patients in each group.The patients in the control group received routine treatments such as dehydration,lipid-lowering therapy,and alteplase,while in the observation group received a combination of control group and intravenous anticoagulant therapy with agatroban.After 4 weeks of treatment,the clinical efficacy of the two groups were compared.the National Institutes of Health Stroke Scale(NIHSS) scores,Modified Rankin Scale(mRs) scores,and Simplified Fugl Meyer Limb Motor Function Scale(FMA)scores before and after 2 and 4 weeks of treatment were compared.The adverse reactions during treatment between two groups were compared.Results Compared with the control group,the total effective rate of the observation group was significantly higher( P<0.05).After 2 and 4 weeks of treatment,compared to the control group,the observation group had significantly lower NIHSS and m Rs scores( P<0.05).After 2 and 4 weeks of treatment,compared to the control group,the observation group had significantly higher FMA scores( P<0.05).During the intervention process,no adverse reactions such as skin bleeding,cerebral hemorrhage,nausea and vomiting,or gingival bleeding were observed in both groups.Conclusion The clinical effect of intravenous anticoagulation combined with ateplase in the treatment of severe acute intracranial arterial stenosis ischemic stroke is significant,which can significantly improve the patient's neurological and motor functions,and has high safety,and it is worth promoting and applying.