目的 觀察阿加曲班對陳舊性椎基底動脈系統(tǒng)腦梗死患者頭暈癥狀的治療效果及安全性。方法 回顧性選擇2022年5月—2022年11月于天津市人民醫(yī)院急診就診主訴為頭暈的既往存在椎基底動脈系統(tǒng)腦梗死患者102例，根據(jù)治療方案將患者分為對照組（n＝50）和試驗(yàn)組（n＝52）。對照組患者急診就診后均接受常規(guī)治療，包括對癥止暈、減輕胃腸道反應(yīng)、糾正水電解質(zhì)紊亂等，給予降壓、降糖及改善腦循環(huán)代謝等治療。試驗(yàn)組在對照組基礎(chǔ)上加用阿加曲班注射液，每天10 mg加入0.9%氯化鈉注射液 100 mL，3 h內(nèi)靜脈滴注，連續(xù)治療 5 d。兩組患者于就診時(shí)及治療第 5天分別進(jìn)行眩暈障礙量表（DHI）評分，根據(jù) DHI 評分進(jìn)行療效判定，并觀察出血并發(fā)癥發(fā)生情況。結(jié)果 試驗(yàn)組總有效率為 96.15%，顯著高于對照組的74.00%（P＜0.05）；試驗(yàn)組顯效率為88.46%，顯著高于對照組的62.00%（P＜0.05）。就診時(shí)，兩組患者DHI評分比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。在治療第5天，兩組DHI評分均顯著低于同組就診時(shí)水平（P＜0.05）；且試驗(yàn)組DHI評分顯著低于對照組（P＜0.05）。治療期間，兩組各有2例患者出現(xiàn)晚間刷牙時(shí)牙齦出血，無嚴(yán)重出血情況發(fā)生。結(jié)論 阿加曲班聯(lián)合常規(guī)治療手段對陳舊性椎基底動脈系統(tǒng)腦梗死后頭暈癥狀具有明顯改善作用，且效果優(yōu)于常規(guī)治療；起效迅速且不增加出血事件發(fā)生率。

Objective To observe the therapeutic effect and safety of argatroban on dizziness symptoms in patients with old vertebrabasilar artery system infarction.Methods A retrospective study was conducted to select 102 patients with vertebra-basilar system cerebral infarction who were admitted to the Department of Emergency of Tianjin Union Medical Center from May 2022 to November 2022 and complained of dizziness. According to the treatment plan, the patients were divided into the control group (n = 50) and the experimental group (n = 52). Patients in the control group received routine treatment after emergency treatment, including symptomatic dizziness control, reduction of gastrointestinal reactions, correction of water and electrolyte disorders, and treatment of hypertension, hypoglycemia, and improvement of cerebral circulation and metabolism. On the basis of the control group, patients in the experimental group were supplemented with Argatroban Injection, with 10 mg added to 100 mL of 0.9% Sodium Chloride Injection, intravenous infusion was performed within three hours for five consecutive days. Patients in two groups were scored with the Dizziness Handicap Inventory (DHI) at the time of treatment and on the 5th day of treatment. The efficacy was evaluated based on the DHI score, and the occurrence of bleeding complications was observed.Results The total effective rate of the experimental group was 96.15%, significantly higher than 74.00% of the control group (P < 0.05). The apparent efficiency of the experimental group was 88.46%, significantly higher than the 62.00% of the control group (P < 0.05). At the time of treatment, there was no statistically significant difference in DHI scores between the two groups (P > 0.05). On the 5th day of treatment, the DHI scores of both groups were significantly lower than the level at the same group's visit (P < 0.05). And the DHI score of the experimental group was significantly lower than that of the control group (P < 0.05). During the treatment period, two patients in each group experienced gum bleeding during evening brushing, with no severe bleeding observed.Conclusion Argatroban combined with conventional treatment has a significant improvement effect on dizziness symptoms after old vertebra-basilar artery system infarction, and the effect is superior to conventional treatment. It takes effect quickly and does not increase the incidence of bleeding events.

R971