河北医科大学学报

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阿加曲班对早期急性脑梗死患者溶栓后的疗效分析#br#

  

  1. 1.河北省沧州市中心医院神经内五科,河北 沧州 061001;2.河北医科大学临床学院实验中心,河北 石家庄 050017
  • 出版日期:2019-08-25 发布日期:2019-08-14
  • 作者简介:谷聚贤(1985-),男,河北无极人,河北省沧州市中心医院主治医师,医学硕士,从事神经内科疾病诊治研究。
  • 基金资助:
    沧州市科技计划项目(162302153)

The therapeutic effect of argatroban on early patients with acute cerebral infarction after thrombolytic therapy#br#

  1. 1.The Fifth Departments of Neurology, Cangzhou Central Hospital, Hebei Province,Cangzhou
    061001, China; 2.Laboratory Center of Clinical College, Hebei Medical
    University, Shijiazhuang 050017, China
  • Online:2019-08-25 Published:2019-08-14

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察阿加曲班对阿替普酶溶栓治疗的早期急性脑梗死患者的临床效果,探求急性脑梗死溶栓后的最佳药物选择及治疗方案。
〖HTH〗方法〖HTSS〗〖KG*2〗将采用阿替普酶溶栓治疗后的早期急性脑梗死患者60例随机分为对照组与试验组各30例。对照组静脉滴注依达拉奉30 mg/次,2次/d,连续7 d。试验组在对照组基础上静脉滴注阿加曲班,前2 d 60 mg/d,后5 d 20 mg/d。于治疗前、治疗7 d、治疗30 d时采用《脑卒中患者临床疗效评定标准》评价2组治疗效果,采用美国国立卫生研究院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)评估神经功能缺损程度,采用日常生活能力量表(Activity of Daily Living Scale,ADL)评估日常生活质量,应用经颅多普勒超声评估脑血管再通情况。
〖HTH〗结果〖HTSS〗〖KG*2〗治疗后,2组NIHSS评分呈逐渐降低趋势,ADL评分和大脑中动脉血流速度呈逐渐升高趋势,〖JP2〗试验组NIHSS评分低于对照组,ADL评分和大脑中动脉血流速度高于对照组,其组间、时点间、组间·〖JP〗时点间交互作用差异均有统计学意义(P<005)。
〖HTH〗结论〖HTSS〗〖KG*2〗与依达拉奉比较,阿加曲班+依达拉奉治疗阿替普酶溶栓后早期急性脑梗死患者,可有效降低神经功能缺损程度,改善日常生活质量和脑血管再通情况,提高治疗效果。

关键词: 脑梗死, 阿加曲班, 依达拉奉

Abstract: [Abstract]〓Objective〖HTSS〗〓To observed the clinical effect of argatroban on early acute cerebral infarction patients treated with alteplase thrombolytic therapy, and to explore the best drug and treatment after thrombolytic therapy for acute cerebral infarction patients.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty early acute cerebral infarction patients treated with alteplase thrombolysis were randomly divided into control group and experimental group, 30 cases in each group. The control group received edaravone by intravenous drip, 30 mg/time, 2 times/d for 7 days. The experimental group received  argatroban by intravenous drip on the basis of the control group, 60 mg/d for the first 2 days and 20 mg/d for the next 5 days. Before treatment, 7 and 30 days after treatment, the linical therapeutic effect of the two groups was evaluated by “Evaluating Criteria for the Clinical Efficacy of Stroke Patients”, the degree of neurological impairment was assessed according to the National Institutes of Health Stroke Scale(NIHSS), the Daily life quality was assessed by Activity of Daily Living Scale(ADL), the state of cerebrovascular recanalization was evaluated by transcranial Doppler ultrasound.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, the NIHSS score of the two groups showed decreased gradually trend, the ADL score and blood flow velocity of middle cerebral artery showed increased gradually trend, the NIHSS score of the experimental group was lower than that of the control group, the ADL score and blood flow velocity of middle cerebral artery were higher than that of the control group. There were statistical significance in the differences among intergroup, time point, intergrouptime point interaction(P<0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Comparing with edaravone, the combination treament of argatroban and edaravone  for early acute cerebral infarction patients treated with alteplase thrombolysis could effectively reduce the neurological impairment degree, improve the daily life quality and cerebral vascular recanalization, increase therapeutic effect.

Key words: brain infarction; argatroban, edaravone