摘要
目的评估阿加曲班联合舒血宁治疗对急性脑梗死患者同型半胱氨酸(Hcy)、血管内皮生长因子(VEGF)、可溶性CD40配体(sCD40L)水平的影响和临床疗效。方法选择2023年6月至2024年3月张家口市第一医院98例急性脑梗死患者作为研究对象,采用分层随机抽样法分为试验组(n=49)和对照组(n=49)。对照组接受常规对症治疗和阿加曲班注射液治疗,试验组在对照组基础上加用舒血宁注射液静脉注射治疗。比较2组患者治疗前(入院时)、治疗后(治疗2周后)神经功能[美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分]、运动功能[简式Fugl-Meyer评定量表(FMA)评分]、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及纤维蛋白原(FIB)、D-二聚体(D-D)水平]、血液流变学指标[血浆黏度(PV)、红细胞聚集指数(EAI)、血细胞比容(HCT)、红细胞沉降率(ESR)]、血清细胞因子(Hcy、VEGF、sCD40L)水平、不良反应(头晕、恶心呕吐、皮疹、食欲减退腹胀、血小板减少、颅内出血)的差异,同时评估2组患者的临床疗效。结果治疗前,2组患者NIHSS评分比较差异无统计学意义(P>0.05);治疗2周后,试验组NIHSS评分低于对照组(P<0.05);试验组治疗总有效率高于对照组(P<0.05)。治疗前,2组患者FMA、mRS评分比较差异无统计学意义(P>0.05);治疗2周后,试验组FMA评分高于对照组,mRS评分低于对照组(P<0.05)。治疗前,2组患者APTT、PT、FIB和D-D比较差异无统计学意义(P>0.05);治疗2周后,试验组APTT和PT高于对照组,FIB和D-D水平低于对照组(P<0.05)。治疗前,2组患者PV、EAI、HCT和ESR比较差异无统计学意义(P>0.05);治疗2周后,试验组PV、EAI、HCT、ESR低于对照组(P<0.05)。治疗前,2组患者Hcy、VEGF和sCD40L比较差异无统计学意义(P>0.05);治疗2周后,试验组Hcy、sCD40L水平低于对照组,VEGF水平高于对照组(P<0.05)。试验组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论阿加曲班联合舒血宁治疗急性脑梗死,能提高患者运动功能,减轻神经功能损伤,改善凝血功能和血液流变学指标,调节血清细胞因子水平,且具有较好的安全性,为急性脑梗死的治疗提供了新的选择。
Objective To evaluate the effects of argatroban combined with Shuxuening injection on homocysteine(Hcy),vascular endothelial growth factor(VEGF),and soluble CD40 ligand(sCD40L)levels,as well as its clinical efficacy in patients with acute cerebral infarction.Methods From June 2023 to March 2024,98 patients with acute cerebral infarction were randomly assigned to experimental group(n=49)or control group(n=49)using stratified random sampling method.The control group received standard symptomatic treatment along with argatroban injection,and the experimental group additionally received intravenous Shuxuening injection.The neurological function[(National Institute of Health stroke scale,NIHSS)and(modified Rankin scale,mRS)scores],motor function[(Fugl‐Meyer assessment scale,FMA)score],coagulation function[(activated partial thromboplastin time,APTT),(prothrombin time,PT),(fibrinogen,FIB),D‐dimer],hemorheology parameters[(plasma viscosity,PV),(erythrocyte aggregation index,EAI),(hematocrit,HCT),(erythrocyte sedimentation rate,ESR)],serum cytokines[(homocysteine,Hcy),(vascular endothelial growth factor,VEGF),(soluble CD40 ligand,sCD40L)],and adverse reactions(dizziness,nausea,vomiting,rash,loss of appetite,abdominal distension,thrombocytopenia,and intracranial hemorrhage)were compare between the two groups.Results There were no significant differences in the NIHSS score,FMA score,mRS score,APTT,PT,FIB,D‐dimer,PV,EAI,HCT,ESR,Hcy,VEGF,or sCD40L between the two groups before treatment(P>0.05).After 2 weeks of treatment,the experimental group showed lower NIHSS score,mRS score,FIB,D‐dimer,PV,EAI,HCT,ESR,Hcy,and sCD40L,and higher total effective rate,FMA score,APTT,PT and VEGF than the control group(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Argatroban combined with Shuxuening injection can enhance motor function,reduce neurological damage,improve coagulation function and hemorheological parameters,regulate serum cytokine levels,offer good safety,and provide a new option for the treatment of acute cerebral infarction.
作者
贾强
田莉
Jia Qiang;Tian Li(Department of Internal Medicine and Critical Care Medicine,Zhangjiakou First Hospital,Zhangjiakou 075000,China)
出处
《海军医学杂志》
2025年第7期710-715,共6页
Journal of Navy Medicine
基金
张家口市重点研发计划项目(2322104D)。
关键词
急性脑梗死
阿加曲班
舒血宁
运动功能
神经功能
Acute cerebral infarction
Argatroban
Shuxuening injection
Motor function
Neurological function
作者简介
通信作者:田莉,电子信箱:18133886281@163.com。
