宋杨君

[摘要] 目的 探討阿加曲班联合阿司匹林、氯吡格雷对进展性脑梗死患者治疗情况。 方法 回顾性分析我院2017年1月至2019年1月收治的进展性脑梗死患者73例，根据用药不同分为联合组（使用阿加曲班联合阿司匹林及氯吡格雷，n=39）与对照组（使用阿司匹林联合氯吡格雷，n=34），比较两组治疗前及治疗后的NIHSS、ADL评分，总有效率及不良反应发生率。 结果 两组治疗前NIHSS评分比较，差异无统计学意义（P>0.05），治疗5 d、10 d，联合组的NIHSS评分均低于对照组，差异有统计学意义（P<0.05）;两组治疗前ADL评分比较，差异无统计学意义（P>0.05）;治疗5 d、10 d后联合组的ADL评分均高于对照组，差异有统计学意义（P<0.05）;联合组的临床总有效率高于对照组，差异有统计学意义（P<0.05）;但两组不良反应总发生率比较，差异无统计学意义（P>0.05）。 结论 对进展性脑梗死患者的治疗中采用阿加曲班联合阿司匹林、氯吡格雷可降低患者神经功能的损害，提高患者的ADL评分及生活能力，不良反应较少，安全性较好。

[关键词] 阿加曲班;阿司匹林;氯吡格雷;进展性脑梗死

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）08-0053-04

Effect of argatroban combined with aspirin and clopidogrel in the treatment of patients with progressive cerebral infarction

SONG Yangjun

Department Ⅱ of Neurology，the Second Hospital of Fushun City in Liaoning Province， Fushun   113001， China

[Abstract] Objective To explore the therapeutic efficacy of argatroban combined with aspirin and clopidogrel in the treatment of patients with progressive cerebral infarction. Methods A total of 73 patients with progressive cerebral infarction admitted to our hospital from January 2017 to January 2019 were retrospectively analyzed， and they were divided into the combined group （argatroban combined with aspirin and clopidogrel， n=39） and the control group （aspirin combined with clopidogrel， n=34） according to different medications. The NIHSS and ADL scores， total efficacy rates and adverse reactions（ADRs） rates of the two groups were compared before and after treatment. Results There was no statistically significant difference in NIHSS scores between the two groups before treatment（P>0.05）. At 5 days， 10 days of treatment，the NIHSS scores of the combined group were all lower than those of the control group， and the difference was statistically significant（P<0.05）. There was no statistically significant difference in ADL scores between the two groups before treatment（P>0.05）. At 5 days，10 days of treatment， the ADL scores of the combined group were higher than those of the control group， and the difference was statistically significant（P<0.05）. The total clinical efficacy rate of the combined group was higher than that of the control group， and the difference was statistically significant（P<0.05）.However， there was no statistically significant difference in the total incidences of ADRs between the two groups（P>0.05）. Conclusion The application of argatroban combined with aspirin and clopidogrel in the treatment of patients with progressive cerebral infarction can reduce the damage of neurological function， improve the ADL scores and improve the living ability of patients， with fewer ADRs and better safety.

[Key words] Argatroban; Aspirin; Clopidogrel; Progressive cerebral infarction

进展性脑梗死是指患者发生急性脑梗死后，临床治疗呈继续恶化的疾病形态，近年来，流行病学研究其有上升趋势，在急性脑梗死患者发生进展性脑梗死比例为26%～43%，致残和致死率均较高[1]。目前临床对进展性脑梗死治疗的侧重点在于恢复患者血液灌注及挽留患者残留的神经元，以保证患者有良好的预后[2]。较早期的溶栓治疗是临床最为常见的治疗措施，但由于大部分患者状态差，时间紧急，易失去治疗的最佳时机，因此寻求有效的治疗方法为临床上较为关注的方向。有研究显示，急性进展性脑梗死的发生与患者的血小板凝集、凝血机制异常及血栓素释放等因素有一定的关系。目前……