阿加曲班治疗2型糖尿病合并穿支动脉梗死患者的临床疗效观察

Clinical Efficacy of Argatroban in the Treatment of Type 2 Diabetes Mellitus with Perforator Artery Infarction

目的:探讨阿加曲班治疗2型糖尿病合并穿支动脉梗死患者的临床疗效,分析其在预防早期神经功能恶化方面的有效性与安全性。方法:选取2021年1月—2022年12月于天津市第一医院就诊的2型糖尿病合并穿支动脉梗死的64例患者,按照治疗方法分为两组,阿加曲班+阿司匹林+氯吡格雷治疗为试验组(n=26),阿司匹林+氯吡格雷治疗为对照组(n=38)。比较两组患者治疗后神经功能,包括早期神经功能恶化(END)发生率、美国国立卫生研究院卒中量表(NIHSS)评分及改良的Rankin量表(mRS);监测治疗期间不良反应的发生情况。结果:治疗1周后,试验组患者END发生率(26.92%vs 42.11%)及NIHSS评分[(6.31±2.31) vs (8.16±4.13)]均低于对照组,治疗3月后试验组患者mRs评分低于对照组[(1.54±0.94) vs (2.21±0.93)](均P<0.05)。两组患者均未出现颅脑出血及肝肾功能下降等不良事件。结论:阿加曲班联合双抗治疗2型糖尿病合并穿支动脉梗死患者,能有效阻止神经功能恶化的发生且安全性较高。

Objective:To investigate the clinical efficacy of argatroban in the treatment of patients with type 2 diabetes mellitus complicated with penetrating artery infarction,and to analyze its effectiveness and safety in preventing early neurologic deterioration.Methods:A total of 64 patients with type 2 diabetes mellitus complicated with penetrating artery infarction who were admitted to Tianjin First Hospital from January 2021 to December 2022 were selected and divided into two groups according to their treatment methods.The experimental group(n=26)was treated with argatroban+aspirin+clopidogrel,while the control group(n=38)was treated with aspirin+clopidogrel.The neurologic function of the two groups was compared after treatment,including the incidence of early neurologic deterioration(END),the National Institutes of Health Stroke Scale(NIHSS)score,and the modified Rankin Scale(mRS).The occurrence of adverse reactions during treatment was also monitored.Results:After one week of treatment,the incidence of END(26.92%vs 42.11%)and NIHSS score[(6.31±2.31)vs(8.16±4.13)]were lower in the experimental group than those of the control group.Three months after treatment,the mRs score of the experimental group was lower than that of the control group[(1.54±0.94)vs(2.21±0.93)](all P<0.05).No adverse events such as intracranial hemorrhage and decreased liver and kidney function were observed in both groups.Conclusion:The combination of argatroban and dual antiplatelet therapy for patients with type 2 diabetes mellitus complicated with penetrating artery infarction can effectively prevent the occurrence of neurologic deterioration and has high safety.