目的 探究阿加曲班聯(lián)合氯吡格雷治療急性后循環(huán)缺血性腦梗死的臨床療效。方法 選取2015年1月—2017年1月河北省滄州中西醫(yī)結(jié)合醫(yī)院神經(jīng)內(nèi)科收治的急性后循環(huán)缺血性腦梗死患者100例，隨機分為對照組和治療組，每組各50例。對照組口服硫酸氫氯吡格雷片，1片/次，1次/d。治療組在對照組治療基礎(chǔ)上給予阿加曲班注射液，60 mg/d，24 h持續(xù)靜脈滴注，連續(xù)治療2 d，第三天將劑量改為10 mg/次，2次/d，持續(xù)5 d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組NIHSS評分、BI指數(shù)、mRS評分。結(jié)果 治療后，對照組和治療組的總有效率分別為88.0%、94.0%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療7、14 d，兩組患者NIHSS評分均顯著降低，BI指數(shù)顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療7、14 d，治療組NIHSS評分低于對照組，BI指數(shù)高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，治療組mRS評分顯著低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 阿加曲班聯(lián)合氯吡格雷治療急性后循環(huán)缺血性腦梗死具有較好的臨床療效，可降低NIHSS評分和mRS評分，具有一定的臨床推廣應(yīng)用價值。

Objective To evaluate the clinical efficacy of argatroban combined with clopidogrel in treatment of acute posterior circulation ischemic cerebral infarction. Methods Patients (100 cases) with acute posterior circulation ischemic cerebral infarction in Neurology Department of Cangzhou Hospital of Integrated TCM-WM Hebei from January, 2015 to January, 2017 were randomly divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were iv administered with Argatroban Injection on the basis of the control group, 60 mg/d for 2 d. On the third day, the dosage should be changed to 10 mg/time, twice daily for 5 d. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS score, BI, mRS score in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 88.0% and 94.0%, respectively, and there was difference between two groups (P < 0.05). On the treatment of 7 and 14 d, NIHSS scores in two groups were decreased, but BI were increased, and the difference was statistically significant in the same group (P < 0.05). On the treatment of 7 and 14 d, NIHSS scores in the treatment group was lower than that in the control group, but BI was higher than that in the control group, and there was difference between two groups (P < 0.05). Conclusion Argatroban combined with clopidogrel has clinical curative effect in treatment of acute posterior circulation ischemic cerebral infarction, can reduce NIHSS score and mRS score, which has a certain clinical application value.