阿加曲班联合双抗对大动脉粥样硬化脑梗死患者的疗效分析

Analysis of therapeutic effect of agatroban combined with double antibody in patients with cerebral infarction caused by large atherosclerosis

目的 分析大动脉粥样硬化(large artery atherosclerosis, LAA)脑梗死患者开展阿加曲班与双抗的联合治疗的疗效。方法 选取2021年1月—2022年12月信阳市中心医院92例LAA脑梗死患者,随机分为2组,对照组46例和研究组46例,对照组给予阿司匹林联合氯吡格雷抗血小板聚集治疗,研究组在对照组的基础上给予阿加曲班治疗,比较凝血功能、NIHSS评分、Barthel指数,以及临床治疗疗效和不良反应发生情况。结果 两组患者治疗14 d的活化部分凝血活酶时间(activated partial thromboplastin time, APTT)升高(P<0.05),D-D降低(P<0.05);研究组患者治疗14 d的APTT与对照组比较更高(P<0.05),D-D更低(P<0.05)。两组治疗14 d的NIHSS降低(P<0.05),Barthel升高(P<0.05);研究组治疗14 d的NIHSS评分与对照组比较更低(P<0.05),Barthel更高(P<0.05)。和对照组的治疗总有效率78.26%比较,研究组的95.65%更高(P<0.05)。与对照组的不良反应发生率21.74%比较,研究组的17.39%无差异(P>0.05)。结论 阿加曲班联合双抗治疗LAA脑梗死患者,可改善凝血功能和神经功能损伤,提高日常生活能力和临床治疗疗效,且不会增加不良反应。

Objective To analyze the curative effect of argatroban combined with double antibody in the treatment of patients with cerebral infarction caused by large artery atherosclerosis(LAA).Methods Totally 92 patients with LAA cerebral infarction attended in the Xinyang Central Hospital from January 2021 to December 2022 were selected and randomly divided into two groups:a control group of 46 cases and a study group of 46 cases.The control group was treated with aspirin combined with clopidogrel for antiplatelet aggregation,while the study group was treated with agatroban on the basis of the control group.Coagulation function,NIHSS score,Barthel index,clinical treatment efficacy,and incidence of adverse reactions were compared.Results Compared with that before treatment,activated partial thromboplastin time(APTT)increased(P<0.05)and D-D decreased(P<0.05)in both groups after treatment;After treatment,compared with the control group,the study group had higher APTT(P<0.05)and lower D-D(P<0.05).Compared with that before treatment,the NIHSS score decreased(P<0.05)and the Barthel index increased(P<0.05)in both groups after treatment;after treatment,compared with the control group,the study group had a lower NIHSS score(P<0.05)and a higher Barthel index(P<0.05).Compared the total effective rate of 78.26%in the control group,the 95.65%in the study group was higher(P<0.05).Compared the 21.74%incidence of adverse reactions in the control group the 17.39%in the study group,there was no difference(P>0.05).Conclusion The treatment of LAA cerebral infarction patients with agatroban combined with dual antibodies can improve coagulation function and neurological damage,improve daily living ability,and clinical treatment efficacy,without increasing adverse reactions.