王润兰 胡婧 侯瑞彬 王美霞 余任喜

[摘要] 目的 評估阿加曲班联合丁苯酞治疗老年急性脑梗死的临床疗效。 方法 选择2018年1月至2019年12月期间入院的80例老年急性脑梗死患者，使用随机数字表法将其分为观察组（n=40）和对照组（n=40）。对照组患者接受常规脑梗死治疗，观察组患者除常规治疗外还接受阿加曲班注射液联合丁苯酞注射液治疗。记录并比较两组临床总有效率、美国国立卫生研究院卒中量表（NIHSS）得分、日常生活活动能力得分（ADL）、脂蛋白相关磷脂酶A2（LP-PLA2）水平及预后。记录两组的不良反应发生率。 结果 治疗后21 d，观察组总有效率为95.00%，高于对照组的77.50%，差异有统计学意义（P<0.05）。观察组NIHSS得分为（5.35±2.12）分，低于对照组的（9.40±1.97）分，差异有统计学意义（P<0.05）。观察组ADL得分为（62.00±2.76）分，高于对照组的（48.33±2.64）分，差异有统计学意义（P<0.05）。观察组治疗后LP-PLA2值为（137.73±3.56）ng/mL，低于对照组的（156.35±7.23）ng/mL，差异有统计学意义（P<0.05）。观察组不良反应总发生率为5.00%，低于对照组的7.50%，差异无统计学意义（P>0.05）。 结论 阿加曲班联合丁苯酞治疗老年急性脑梗死效果显著，具有修复神经系统损伤、改善日常生活活动能力、调节LP-PLA2水平的作用，具有良好的临床应用价值。

[关键词] 脑梗死;丁苯酞;阿加曲班;脂蛋白相关磷脂酶

[中图分类号] R743.33          [文献标识码] B        &nbsp; [文章编号] 1673-9701（2021）32-0040-04

[Abstract] Objective To evaluate the clinical efficacy of argatroban combined with butylphthalide in the treatment of acute cerebral infarction in the elderly. Methods A total of 80 elderly patients with acute cerebral infarction who were admitted to the hospital from January 2018 to December 2019 were selected and divided into the observation group （n=40） and the control group （n=40） by a random number table. Patients in the control group received conventional treatment for cerebral infarction， while patients in the observation group received argatroban injection and butylphthalide injection in addition to conventional treatment. The total clinical effectiveness rate， the National Institutes of Health Stroke Scale （NIHSS） score， the activity of daily living （ADL） score， the lipoprotein-related phospholipase A2 （LP-PLA2） level and prognosis were recorded and compared between the two groups. The incidence of adverse reactions in the two groups was recorded. Results On the 21st day after treatment， the total effective rate of the observation group （95.00%） was higher than that of the control group （77.50%）， with statistically significant difference（P<0.05）. The NIHSS score of the observation group （5.35±2.12）points was lower than that of the control group （9.40±1.97）points， with statistically significant difference （P<0.05）. The ADL score of the observation group （62.00±2.76）points was higher than that of the control group （48.33±2.64）points， with statistically significant difference （P<0.05）. The postoperative LP-PLA2 value of the observation group （137.73±3.56）ng/mL was lower than that of the control group （156.35±7.23）ng/mL， with statistically significant difference （P<0.05）. The incidence of adverse reactions in the observation group （5.00%） was lower than that in the control group （7.50%）， without statistically significant difference （P>0.05）. Conclusion Argatroban combined with butylphthalide shows significant effects in the treatment of acute cerebral infarction in the elderly. It can repair nervous system damage， improve activities of daily living， and regulate the level of LP-PLA2. It has good clinical application value.

[Key words] Cerebral infarction; Butylphthalide; Argatroban; Lipoprotein-related phospholipase

脑梗死（Cerebral infarction，CI）是世界性的重大健康问题。它是第二大死亡原因，也是第三大最常见的致残原因[1]。用于CI的有效疗法较少，目前溶栓治疗被认为是急性脑梗死（Acute cerebral infarction，ACI）最有效的治疗方法，然而该方法治疗时间窗口狭窄，仅有极少数患者可应用静脉溶栓方法进行治疗[2]。……