阿加曲班联合阿司匹林与氯吡格雷治疗急性脑梗死患者的效果

Effects of Argatroban combined with Aspirin and Clopidogrel in treatment of patients with acute cerebral infarction

目的:观察阿加曲班联合阿司匹林与氯吡格雷治疗急性脑梗死患者的效果。方法:选取2022年1月至2023年1月该院收治的68例急性脑梗死患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各34例。对照组采用阿司匹林联合氯吡格雷治疗,研究组在对照组基础上增加阿加曲班治疗,比较两组临床疗效,治疗前后肢体运动功能[Fugl-Meyer运动功能评分量表(FMA)]评分、日常活动能力[Barthel指数(BI)]评分、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、血小板指标(聚集率、黏附率)水平、脑血流动力学指标[大脑前动脉(ACA)、基底动脉(BA)血流速度]水平和不良反应发生率。结果:研究组治疗总有效率为88.24%(30/34),高于对照组的67.65%(23/34),差异有统计学意义(P<0.05);治疗后,两组FMA、BI评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组NIHSS评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组血小板聚集率、黏附率均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组ACA、BA血流速度均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿加曲班联合阿司匹林与氯吡格雷治疗急性脑梗死患者可提高治疗总有效率、肢体运动功能评分、日常生活能力评分和脑血流动力学指标水平,降低神经功能缺损程度和血小板指标水平,其效果优于阿司匹林联合氯吡格雷治疗。

Objective:To observe effects of Argatroban combined with Aspirin and Clopidogrel in treatment of patients with acute cerebral infarction.Methods:A prospective study was conducted on 68 patients with acute cerebral infarction admitted to this hospital from January 2022 to January 2023.According to the random number table method,they were divided into study group and control group,34 cases in each group.The control group was treated with Aspirin combined with Clopidogrel,while the study group was treated with Argatroban on the basis of those of the control group.The clinical efficacy,the limb motor function[Fugl-Meyer motor assessment(FMA)]score,the daily activity ability[Barthel index(BI)]score,the neurological deficit degree[National Institutes of Health stroke scale(NIHSS)]score,the platelet index[aggregation rate,adhesion rate]levels,the cerebral hemodynamic index[anterior cerebral artery(ACA),basilar artery(BA)blood flow velocity]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 88.24%(30/34),which was higher than 67.65%(23/34)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the FMA and BI scores of the two groups were higher than those before the treatment,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).The NIHSS scores of the two groups were lower than those before the treatment,that in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).The platelet aggregation rate and the adhesion rate of the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The blood flow velocities of ACA and BA in the two groups was higher than those before the treatment,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Argatroban combined with Aspirin and Clopidogrel in the treatment of the patients with acute cerebral infarction can improve the total effective rate of treatment,the limb motor function scores,the daily living ability scores and the cerebral hemodynamics index levels,and reduce the neurological deficit degree score and the platelet index levels.Moreover,it is superior to Aspirin combined with Clopidogrel treatment.