中国合理用药探索2025，Vol.22Issue(4)：46-52,7.DOI:10.3969/j.issn.2096-3327.2025.04.007
阿加曲班联合抗血小板治疗中型大动脉粥样硬化型缺血性脑卒中的效果
Efficacy of Argatroban Combined with Antiplatelet Therapy in the Treatment of Moderate Large Artery Atherosclerotic Ischemic Stroke
摘要
Abstract
Objective:To investigate the efficacy and safety of argatroban combined with antiplatelet therapy in the treatment of moderate large artery atherosclerotic ischemic stroke(LAA-IS),and to analyze the therapeutic effect in different stroke subtypes.Methods:The clinical data of 370 patients with moderate LAA-IS visited the department of neurology from March 2022 to August 2023 were retrospectively collected.The patients were divided into the control group(n=153)and the observation group(n=217)according to different treatments.The control group was treated with antiplatelet therapy,and the observation group was treated with argatroban injection in addition to the control treatment.The neurological function score[National Institutes of Health Stroke Scale(NIHSS)score],short-term prognosis score[modified Rankin scale(mRS)score],the incidence of early neurological deterioration(END)and hemorrhage were compared between the two groups.Stroke subtype analysis was performed by the infarction site.Results:The NIHSS scores of the two groups were decreased after 3 and 7 days of treatment(P<0.05),and lower in the observation group than those in the control group(P<0.05).The proportions of 90-day mRS score 0～2 and 90-day mRS score 0～1 in the observation group were higher than those in the control group(P<0.05).The incidence of END in the observation group(19.82%)was lower than that in the control group(29.41%,χ2=4.558,P=0.033).There was no statistically significant difference in the incidence of hemorrhage between the two groups(χ2=0.007,P=0.935).There was no statistically significant difference in NIHSS score before treatment,90-day mRS score 0～2,90-day mRS score 0～1,END incidence and hemorrhage between patients with anterior circulation infarction and patients with posterior circulation infarction(P>0.05).The NIHSS scores of patients with anterior circulation infarction was lower than that of patients with posterior circulation infarction at 3 and 7 days after treatment(P<0.05).Conclusion:Argatroban combined with antiplatelet therapy can effectively improve the early neurological deficiency and prognosis,reduce the incidence of END without increasing the risk of hemorrhage in patients with moderate LAA-IS,especially in patients with anterior circulation infarction.关键词
大动脉粥样硬化型/缺血性脑卒中/中型/抗血小板/阿加曲班/神经功能/安全性Key words
large artery atherosclerotic/ischemic stroke/moderate/antiplatelet/argatroban/neurological function/safety分类
临床医学引用本文复制引用
汪梦园,白永杰,杨幸文,周俊梅,孟凡超..阿加曲班联合抗血小板治疗中型大动脉粥样硬化型缺血性脑卒中的效果[J].中国合理用药探索,2025,22(4):46-52,7.基金项目
河南省医学科技攻关计划项目(LHGJ20220820) （LHGJ20220820）
