阿加曲班联合普罗布考治疗进展性卒中患者效果及对炎症因子、促动脉硬化指数的影响

Effect of agatroban combined with Probucol in the treatment of progressive stroke patients and its influence on inflammatory factors and atherogenic index of plasma

目的 探讨阿加曲班联合普罗布考治疗进展性卒中的临床疗效,并分析其对炎症因子、促动脉硬化指数(AIP)、血小板功能的影响。方法 回顾性选取2019年10月至2022年10月进展性卒中患者80例,依据治疗方案不同分为单一组40例(普罗布考治疗)、联合组40例(阿加曲班联合普罗布考治疗)。比较两组临床疗效、安全性及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评定量表(BI)评分、促动脉硬化指数(AIP)、神经功能[B型利钠肽(BNP)、神经元特异性烯醇化酶(NSE)、β淀粉样蛋白-1-42(Aβ1-42)]、炎症因子[白细胞介素-1β(IL-1β)、单核细胞趋化蛋白-1(MCP-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)]、血小板功能。结果 联合组临床疗效优于单一组(P<0.05);不良反应对比无明显差异(P>0.05);与单一组比较,联合组治疗后NIHSS评分、AIP降低,BI评分升高(P<0.05);与单一组比较,联合组治疗后血清BNP、NSE、Aβ1-42、IL-1β、MCP-1、Lp-PLA2水平降低(P<0.05);与单一组比较,联合组治疗后血小板聚集率、血小板体积降低(P<0.05)。结论 阿加曲班联合普罗布考治疗进展性卒中的疗效确切,可改善神经功能、动脉粥样硬化,提高日常生活能力,减轻炎症反应程度,抑制血小板活化,且具有一定安全性。

Objective To investigate the clinical efficacy of agatroban combined with probucol in the treatment of progressive stroke,and to analyze the effects of agatroban on inflammatory fac-tors,atherogenic index of plas-ma(AIP)and platelet function.Methods A total of 80 patients with progressive stroke from October 2019 to October 2022 were retrospectively selected and di-vided into single group(40 cases)(probucol)and combined group(40 cases)(agatroban com-bined with probucol)according to different treatment plans.Compare the clinical efficacy,safety of the two groups,as well as National Institutes of Health Stroke Scale(NIHSS)score,Barthel Index Rating Scale(BI)score,atherogenic index of plas-ma(AIP),neurological function[B-type natriuretic peptide(BNP),neuron-specific enolase(NSE),β-amyloid-1-42(Aβ1-42)],in-flammatory factors[interleukin-1β(IL-1β),monocyte chemoattractant protein-1(MCP-1),lipo-protein-associated phospholipase A2(Lp-PLA2)],platelet function before and after treatment.Results The clinical effect of combined group was better than that of single group(P<0.05).There was no significant difference in adverse reactions(P>0.05).Compared with the single group,NIHSS score and AIP score of the combined group were decreased after treatment,and BI score was increased(P<0.05).Compared with single group,serum levels of BNP,NSE,Aβ1-42,IL-1β,MCP-1 and Lp-PLA2 in combination group were decreased after treatment(P<0.05).Compared with the single group,the platelet aggregation rate and platelet volume in the combined group were decreased after treatment(P<0.05).Conclusion Agatroban combined with probuccal is effective in the treatment of progressive stroke,which can improve nerve func-tion,atherosclerosis,improve daily living ability,reduce inflammation,inhibit platelet activation,and has certain safety.