目的 觀察阿加曲班注射液聯(lián)合阿司匹林腸溶片序貫治療對進(jìn)展性腦卒中的療效。方法 選取2019年1月1日—2021年4月1日重慶市巴南區(qū)第二人民醫(yī)院神經(jīng)內(nèi)科收治的91例進(jìn)展性腦卒中患者為研究對象，進(jìn)行回顧性研究。根據(jù)治療方法將患者分為對照組（n=54）和觀察組（n=37）。兩組患者均予以改善循環(huán)、穩(wěn)定斑塊等常規(guī)治療；對照組給予阿司匹林腸溶片100 mg/次，1次/d；觀察組予以阿加曲班注射液60 mg/次，1次/d，24 h持續(xù)靜脈泵入，第3～7天改為10 mg/次，2次/d，靜脈滴注，7 d后予以阿司匹林腸溶片100 mg/次，1次/d，兩組均治療14 d。觀察兩組患者的臨床療效，比較兩組患者治療后及出院后3個(gè)月美國國立衛(wèi)生研究院腦卒中（NIHSS）量表評分及改良Rankin量表（mRS）評分，并觀察出血、神經(jīng)功能惡化、過敏等不良事件發(fā)生情況。結(jié)果 兩組治療14 d后，觀察組總有效率為81.08%，顯著高于對照組的57.41%（P<0.05）。治療14 d后，觀察組NIHSS評分較對照組顯著降低（P<0.05）；出院3個(gè)月后觀察組NIHSS評分也顯著低于對照組（P<0.05），且mRS評分較對照組顯著降低（P<0.05）。觀察組和對照組的總藥物不良反應(yīng)發(fā)生率分別為8.1%和9.2%，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 阿加曲班注射液聯(lián)合阿司匹林腸溶片序貫治療能減輕進(jìn)展性腦卒中患者的神經(jīng)功能缺損，并能有效改善3個(gè)月后的日常獨(dú)立生活能力，且不增加出血等不良事件的發(fā)生率。

Objective To investigate the therapeutic effect of sequential treatment of Argatroban Injection combined with aspirin on progressive stroke. Methods a retrospective study was conducted on 91 patients with progressive stroke treated in the Department of Neurology of the Second People's Hospital of Banan District, Chongqing from January 1, 2019 to April 1, 2021. According to the treatment methods, the patients were divided into control group (n=54) and experimental group (n=37). Patients in both groups were given routine treatment such as improving circulation and stabilizing plaque. Patients in the control group was given Aspirin Enteric Coated Tablets 100 mg/time, once a day. Patients in the experimental group were given Argatroban Injection 60 mg/time, once a day, continuously pumped intravenously for 24 h, changed to 10 mg/time, twice a day, intravenously on the 3rd-7th day, and Aspirin Enteric Coated Tablets 100 mg/time, once a day after seven days. Patients in both groups were treated for 14 days. The clinical efficacy of the two groups was observed. The scores of NIHSS and mRS were compared between the two groups after treatment and three months after discharge, and the incidence of adverse events such as bleeding, deterioration of neurological function and allergy were observed. Results After 14 days of treatment, the total effective rate in the observation group was 81.08%, which was significantly higher than 57.41% in the control group (P<0.05). After 14 days of treatment, the NIHSS score in the experimental group was significantly lower than that in the control group (P<0.05). Three months after discharge, the NIHSS score of the experimental group was also significantly lower than that of the control group (P<0.05), and the mRS score was significantly lower than that of the control group (P<0.05). The total incidence of adverse drug reactions in the experimental group and the control group were 8.1% and 9.2% respectively, with no significant difference (P>0.05). Conclusion The sequential treatment of Argatroban Injection combined with Aspirin Enteric Coated Tablets can reduce the neurological deficit of patients with progressive stroke, effectively improve the ability of independent daily living after three months, and does not increase the incidence of adverse events such as bleeding.

R971