目的 探索阿加曲班不同給藥方式對(duì)超早期急性缺血性腦卒中患者的療效及安全性。方法 回顧性選取2019年2月—2020年11月在肇慶市第一人民醫(yī)院神經(jīng)內(nèi)科住院的急性缺血性腦卒中患者64例為研究對(duì)象，根據(jù)給藥方式不同將患者分為靜脈滴注組（靜滴組）和微泵＋靜脈滴注組（微泵＋靜滴組），靜滴組患者給予阿加曲班注射液，10 mg阿加曲班注射液加入0.9%氯化鈉注射液250 mL中，靜脈滴注給藥，每天2次，連續(xù)給藥（7±1）d；微泵＋靜滴組患者給予阿加曲班注射液，持續(xù)微泵（10 mL·h^-1）24 h或者48 h，其后采用10 mg阿加曲班注射液加入0.9%氯化鈉注射液250 mL中，靜脈滴注給藥，每天2次，連續(xù)給藥（5±2）d。比較兩組患者臨床治療效果及不良反應(yīng)。結(jié)果 靜滴組總有效率（55.88%）高于微泵＋靜滴組（53.55%），但差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組患者出院時(shí)美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分均低于本組入院時(shí)NIHSS評(píng)分（P＜0.05），兩組間出院時(shí)NIHSS評(píng)分比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組患者出院時(shí)改良Rankin量表（MRS）≤1分的患者占比比較，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05），靜滴組占比更高。兩組患者出院時(shí)MRS評(píng)分≤2分的患者占比比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組均未發(fā)生出血事件及新發(fā)心腦血管事件。結(jié)論 阿加曲班靜脈滴注給藥治療急性缺血性腦卒中的療效顯著，安全性高。

Objective To explore efficacy and safety of different administration Methods of argatroban in patients with ultra early acute ischemic stroke. Method A retrospective study was conducted on 64 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at the First People's Hospital of Zhaoqing City from February 2019 to November 2020. The patients were divided into an intravenous drip group (intravenous drip group) and a micropump + intravenous drip group (micropump+intravenous drip group) based on different administration methods. The intravenous drip group received Argatroban Injection, with 10 mg of Argatroban Injection added to 250 mL of 0.9% Sodium Chloride Injection, intravenous drip administration, twice a day, continuous for (7 ±1) days. The patients in the micropump+intravenous drip group were given Argatroban Injection for 24 or 48 hours with a continuous micropump (10 mL·h^-1). Afterwards, 10 mg Argatroban Injection was added to 250 mL of 0.9% Sodium Chloride Injection, and administered intravenously twice a day for a continuous period of (5 ±2) days. Compare the clinical treatment efficacy and adverse reactions between two groups of patients. Results The total effective rate of the intravenous drip group (55.88%) was higher than that of the micropump+intravenous drip group (53.55%), but the difference was not statistically significant (P > 0.05). The National Institutes of Health Stroke Scale (NIHSS) scores at discharge for both groups of patients were lower than the NIHSS scores at admission for this group (P < 0.05), and there was no statistically significant difference in NIHSS scores at discharge between the two groups (P > 0.05). There was a statistically significant difference in the proportion of patients with a Modified Rankin Scale (MRS) score of ≤ 1 between the two groups at discharge (P < 0.05). There was no statistically significant difference in the proportion of patients with MRS scores ≤ 2 when discharged between the two groups (P > 0.05). There were no bleeding events or new cardiovascular or cerebrovascular events in both groups. Conclusion Argatroban intravenous infusion has a significant therapeutic effect and high safety in the treatment of acute ischemic stroke.

R971