目的 觀察阿加曲班聯(lián)合尤瑞克林治療急性進(jìn)展性腦卒中的療效及安全性。方法 回顧性選取2019年1月—2021年6月揭陽(yáng)市人民醫(yī)院神經(jīng)內(nèi)科診治的急性進(jìn)展性腦卒中患者80例，根據(jù)治療方法分成對(duì)照組和觀察組，每組各40例。兩組患者均嚴(yán)格依照急性缺血性腦血管病指南，予以規(guī)范診治，對(duì)照組應(yīng)用注射用尤瑞克林0.15 PNA單位加入至0.9%氯化鈉注射液100 mL中靜脈滴注，1次/d，靜脈滴注給藥時(shí)間不少于50 min，用藥期間密切監(jiān)測(cè)血壓變化情況，療程為14 d。觀察組在應(yīng)用注射用尤瑞克林的同時(shí)，加用阿加曲班注射液，在開(kāi)始治療的第1～2天，阿加曲班注射液60 mg加入至0.9%氯化鈉注射液380 mL中，輸液泵泵入，24 h持續(xù)不間斷靜脈輸注，從第3天起，阿加曲班注射液10 mg加入至0.9%氯化鈉注射液250 mL中，輸液泵泵入，持續(xù)3 h靜脈輸注，12 h/次，用藥5 d，療程為7 d。分別于治療前、治療后采用美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)估患者的神經(jīng)缺損程度，采用日常生活活動(dòng)功能量表（ADL）評(píng)估兩組患者生活自理能力。同時(shí)監(jiān)測(cè)血細(xì)胞、肝腎功能等生化指標(biāo)及凝血指標(biāo)的動(dòng)態(tài)變化，觀察治療過(guò)程中出現(xiàn)的不良反應(yīng)情況。結(jié)果 治療后，觀察組的總有效率為92.5%，顯著高于對(duì)照組的72.5%，治療后對(duì)照組和觀察組NIHSS評(píng)分均較治療前顯著降低（P<0.05），ADL評(píng)分顯著升高（P<0.05）；治療后觀察組NIHSS評(píng)分顯著低于對(duì)照組（P<0.05），ADL評(píng)分顯著高于對(duì)照組（P<0.05）。兩組患者的不良反應(yīng)發(fā)生率低，未出現(xiàn)嚴(yán)重不良反應(yīng)。結(jié)論 急性進(jìn)展性腦卒中患者采用阿加曲班注射液聯(lián)合尤瑞克林的治療方案，病情得到有效控制，病殘率較低，日常獨(dú)立生活能力提高，且安全性好，有較高的臨床推廣應(yīng)用價(jià)值。

Objective To observe the efficacy and safety of argatroban combined with urecolin in the treatment of acute progressive stroke. Methods 80 patients with acute progressive stroke treated in the Department of Neurology of Jieyang People's Hospital from January 2019 to June 2021 were selected retrospectively. According to the treatment methods, patients were divided into control group and observation group, with 40 cases in each group. The patients in both groups were treated in strict accordance with the guidelines for acute ischemic cerebrovascular disease. Patients in the control group were injected with 0.15 PNA unit of urinary kallikrein for injection into 100 mL of 0.9% sodium chloride injection, once a day, for no less than 50 min. The changes of blood pressure were closely monitored during the medication period, and the course of treatment was 14 days. Patients in the observation group were added with Argatroban Injection while using urinary kallidinogenase for injection. On the first to second days of treatment, 60 mg of Argatroban Injection was added to 380 mL of 0.9% sodium chloride injection, pumped by infusion pump, and continued intravenous infusion for 24 h. From the third day, 10 mg of Argatroban Injection was added to 250 mL of 0.9% sodium chloride injection, pumped by infusion pump, continuous intravenous infusion for three hours, 12 h/time, five day, and the course of treatment was seven days. National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of nerve defect before and after treatment, and activity of daily living (ADL) scale was used to evaluate the self-care ability of the two groups. At the same time, the dynamic changes of biochemical indexes such as blood cells, liver and kidney function and coagulation indexes were monitored, and the adverse reactions during treatment were observed. Results After treatment, the total effective rate of the observation group was 92.5%, significantly higher than 72.5% of the control group. After treatment, the NIHSS scores of the control group and the observation group were significantly lower than those before treatment (P<0.05), and the ADL scores were significantly higher (P<0.05). After treatment, the NIHSS score of the observation group was significantly lower than that of the control group (P<0.05), and the ADL score of the observation group was significantly higher than that of the control group (P<0.05). The incidence of adverse reactions in the two groups was low, and there were no serious adverse reactions. Conclusion The treatment of acute progressive stroke patients with Argatroban Injection combined with urecolin can effectively control the condition, reduce the disability rate, improve the ability of daily independent living, and have good safety. It has high clinical application value.

R971