摘要
目的:对比观察小剂量阿加曲班与阿司匹林治疗急性脑梗死患者的疗效与安全性。方法:136例急性脑梗死患者随机均分为观察组和对照组。两组患者均给予抗颅内压增高、抗氧化应激、脑神经保护、吸氧、控制血压血糖、抗感染、调节水电解质酸碱平衡等常规治疗。在此基础上,对照组患者给予注射用精氨酸阿司匹林100 mg,加入0.9%氯化钠注射液250 ml,静脉滴注,每日1次。观察组患者给予阿加曲班注射液40 mg,加入0.9%氯化钠注射液500 ml中,24 h持续静脉滴注,连用2 d;2 d后剂量减至10mg,加入0.9%氯化钠注射液100 ml中,静脉滴注,每日1次,连用5 d。两组患者疗程均为7 d。观察两组患者的临床疗效,治疗前后美国国立卫生院卒中量表(NIHSS)评分、Bathel指数评分及不良反应发生情况,并随访2年观察脑梗死复发情况。结果:观察组患者总有效率显著高于对照组,1年、2年脑梗死复发率均显著低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分显著低于同组治疗前,观察组低于对照组;Bathel指数评分显著高于同组治疗前,观察组高于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,小剂量阿加曲班较阿司匹林可显著改善急性脑梗死患者的神经功能、降低脑梗死复发率,且安全性较好。
OBJECTIVE：To observe the effect and safety of small-dose argatroban vs. aspirin in the treatment of acute cerebral infarction. METHODS：136 patients with acute cerebral infarction were randomly divided into observation group and control group.All patients were given routine treatment,such as anti-intracranial pressure,oxidative stress,brain protection,oxygen,blood pressure,blood sugar control,anti-infective,water and electrolyte acid-base balance,etc. Based on it,control group was treated with Arginine aspirin for injection 100 mg,adding into 0.9% Sodium chloride injection 250 ml,iv,once a day. Observation group was treated with Argatroban injection 40 mg,adding into 0.9% Sodium chloride injection 500 ml,24 h continuous infusion for continuous 2 d,iv;then dose was decreased to 10 mg,adding into 0.9% Sodium chloride injection 100 ml,iv,once a day,for continuous 5 d. The course of both was 7 d. The clinic data was observed,including clinical efficacy,NIHSS（National Institutes of Health Stroke Scale）score,Bathel index scores before and after treatment,and incidence of adverse reactions. The recurrence rate of cerebral infraction during the 2-year follow-up period was observed. RESULTS：The total effective rate in observation group was significantly higher than control group,the recurrence rates of cerebral infarction in observation group within 1 and 2 year（s）were significantly lower than control group,with significant difference（P〈0.05）. After treatment,the NIHSS score in 2 groups were significantly lower than before,observation group was lower than control group;Bathel score was significantly higher than before,and observation group was higher than control group,with significant differences（P〈0.05）. There were no significant differences in the incidence of adverse reactions between 2 groups（P〉0.05）. CONCLUSIONS：Based on the conventional treatment,compared with aspirin, small-dose argatroban can significantly commute the nerve function of acute cerebral infarction,and reduce the recurrence rate of cerebral infarction,with good safety.
出处
《中国药房》
CAS
北大核心
2015年第21期2933-2935,共3页
China Pharmacy
关键词
阿加曲班
阿司匹林
急性脑梗死
复发率
神经功能
Argatroban
Aspirin
Acute cerebral infarction
Recurrence rate
Nerve function
作者简介
副主任医师。研究方向：神经内科脑血管疾病。电话：022．82125806。E—mail：yffan_2008@sina．com
