急性缺血性脑卒中超溶栓时间窗采用阿加曲班与替罗非班治疗的效果比较

Comparison on the efficacy of argatroban and tirofiban in the treatment of acute ischemic stroke in expanded time window of thrombolysis

目的比较急性缺血性脑卒中超溶栓时间窗采用阿加曲班和替罗非班治疗的效果。方法98例急性缺血性脑卒中患者,按随机方法分为观察组(50例)与对照组(48例)。两组患者均在超溶栓时间窗接受溶栓治疗,观察组用药阿加曲班,对照组应用替罗非班。比较两组患者临床疗效、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血小板计数(PLT)、血小板内皮细胞粘附分子-1(PECAM-1)]。结果治疗后,观察组临床总有效率96.00%与对照组的85.42%相比,差异不显著(P>0.05)。治疗后,两组患者APTT、PT、PLT、PECAM-1水平均较治疗前改善(P<0.05);但观察组患者APTT(28.27±2.49)s、PT(11.29±0.86)s、PLT(140.33±16.37)×10^(9)/L、PECAM-1(42.17±6.72)μg/L与对照组的(28.89±3.54)s、(11.25±1.66)s、(144.83±23.44)×10^(9)/L、(41.79±6.77)μg/L比较,差异不显著(P>0.05)。结论在超溶栓时间窗对急性缺血性脑卒中患者进行溶栓治疗时,通过阿加曲班和替罗非班进行治疗都能达到明显的效果,可以实现对患者凝血功能的改善,值得推荐。

Objective To compare the effect of argatroban and tirofiban in the treatment of acute ischemic stroke in expanded time window of thrombolysis.Methods 98 patients with acute ischemic stroke were randomly divided into an observation group(50 cases)and a control group(48 cases).Both groups received thrombolytic therapy in expanded time window.The observation group received argatroban and the control group received tirofiban.The clinical efficacy,coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),platelet count(PLT)and platelet endothelial cell adhesion molecule-1(PECAM-1)]of the two groups were compared.Results After treatment,the total clinical effective rate of the observation group was 96.00%,and there was no significant difference compared with 85.42%of the control group(P>0.05).After treatment,the levels of APTT,PT,PLT,and PECAM-1 in both groups were improved compared with those before treatment(P<0.05).The observation group had APTT of(28.27±2.49)s,PT of(11.29±0.86)s,PLT of(140.33±16.37)×10^(9)/L,and PECAM-1 of(42.17±6.72)μg/L,and the difference was not significant when compared with(28.89±3.54)s,(11.25±1.66)s,(144.83±23.44)×10^(9)/L,and(41.79±6.77)μg/L in the control group(P>0.05).Conclusion In acute ischemic stroke patients in expanded time window of thrombolysis,both argatroban and tirofiban can achieve obvious effects and can improve the coagulation function of patients,which is worthy of recommendation.