目的 觀察阿加曲班治療急性進(jìn)展性腦梗死的臨床療效及安全性.方法 選取2013年5月—2014年5月在內(nèi)蒙古自治區(qū)人民醫(yī)院住院的急性進(jìn)展性腦梗死患者50例,隨機(jī)分為治療組(25例)和對(duì)照組(25例).治療組患者第1、2天每天用阿加曲班注射液60 mg以500 mL生理鹽水稀釋,24 h持續(xù)靜脈泵注;其后的5 d用阿加曲班20 mg以100 mL生理鹽水稀釋,分早晚2次持續(xù)靜脈泵注,每次3 h,持續(xù)治療7 d.對(duì)照組靜脈滴注注射用奧扎格雷鈉,80 mg/次,以500 mL生理鹽水稀釋,2次/d,連續(xù)7 d.兩組其他治療持續(xù)14 d.治療后,觀察兩組患者的臨床療效,同時(shí)比較治療前后兩組患者的NIHSS評(píng)分和Barthel指數(shù)變化.結(jié)果 治療組和對(duì)照組總有效率分別為88.0%、72.0%,兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05).兩組治療14 d與治療前比較NIHSS評(píng)分均明顯降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05).兩組治療后Barthel指數(shù)較治療前均明顯提高,治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05).治療后,治療組這兩項(xiàng)指標(biāo)改善程度優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05).結(jié)論 阿加曲班注射液治療急性進(jìn)展性腦梗死具有較好的臨床療效,可降低NIHSS評(píng)分,提高Barthel指數(shù),值得臨床推廣應(yīng)用.

Objective To explore the effect and safety of Argatroban Injection in treatment of acute progressive cerebral infarction. Methods Patients with acute progressive cerebral infarction who came to Inner Mongolia People's Hospital from May 2013 to May 2014 (50 cases) were randomly divided into treatment (25 cases) and control (25 cases) groups. The patients in the treatment group were treated with Argatroban Injection (60 mg diluted with 500 mL physiological saline) through 24 h continuous iv pump infusion on the first 2 d. The next 5 d they were treated with Argatroban Injection (20 mg diluted with 100 mL physiological saline), through continuous 3 h iv infusion twice daily in the morning and evening. They were treated for 7 d. The patients in the control group were iv administered with Ozagreiner for injection 80 mg/time which was diluted with 500 mL physiological saline, twice daily, for 7 d. Ather treatment in two groups lasted 14 d. After treatment, the treatment efficacy was evaluated, while the changes of NIHSS score and Barthel indexes in two groups were compared. Results The efficacies in the treatment and control groups were 88.0% and 72.0%, respectively, with differences between the two groups (P < 0.05). Within 14 d after the treatment, the NIHSS scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant in the same group (P < 0.05). After treatment, Barthel index of the two groups were significantly improved than those before treatment, and the difference was statistically significant in the same group (P < 0.05). After treatment, the two indicators in the treatment group improved better than those in the control group, with the significant difference between two groups (P < 0.05). Conclusion Argatroban Injection has good clinical effect in treatment of acute progressive cerebral infarction, and can reduce the NIHSS score and improve the Barthel index, which is worthy of clinical application.