赣南医科大学学报2025，Vol.45Issue(11)：1050-1055,6.DOI:10.3969/j.issn.2097-7174.2025.11.004
阿替普酶静脉溶栓联合阿加曲班序贯治疗急性脑梗死患者的有效性与安全性研究
The efficacy and safety of intravenous thrombolysis with alteplase combined with sequential argatroban therapy for acute cerebral infarction
摘要
Abstract
Objective:To evaluate the efficacy and safety of intravenous thrombolysis with Alteplase combined with Sequential Argatroban therapy for acute cerebral infarction(ACI).Methods:A total of 90 eligible patients with ACI were randomly divided into three groups using a random number table,(30 patients each)using a random number table method.All patients received conventional supportive treatments,including blood pressure regulation,lipid-lowering and plaque-stabilizing therapy,and neuroprotection.In addition,Group A was treated with intravenous thrombolysis using alteplase,while Groups B and C received sequential therapy with high-dose and low-dose argatroban,respectively,after alteplase intravenous thrombolysis.Head CT scans were repeated 24 hours after thrombolytic therapy to assess cerebral hemor-rhage.National Institute of Health Stroke Scale(NIHSS)scores and Barthel Index(BI)scores were evaluated before treat-ment and at 3 months post-treatment.Complications and mortality rates were also observed in all groups.The degree of neurological function improvement and activities of daily living capabilities were compared among the three groups.Results:Prior to treatment,no significant statistical difference was observed in NIHSS scores,BI scores,modified Rankin Scale(mRS)scores,or the number of patients with mRS≤2 among the three groups(P＞0.05).After 3 months,NIHSS scores decreased in all groups.There was no significant difference in Group A when comparing pre-and post-treatment scores(P＞0.05),while significant differences were observed in both the high-dose and low-dose experimental groups(P＜0.01).Although the high-dose and low-dose experimental groups showed a greater downward trend in NIHSS scores compared to the control group,the differences were not statistically significant(P＞0.05).mRS scores decreased,while BI scores and the number of patients with good functional outcomes increased in the high-dose and low-dose experimental groups,which were significantly better than the control group,with statistically significant differences both within and between groups(P＜0.05).There were no significant differences in total complications and mortality rates among the three groups(P＞0.05).Conclusion:Sequential therapy with either dose of argatroban after alteplase intravenous thrombolysis for ACI yields better clinical outcomes compared to alteplase intravenous thrombolysis alone.The efficacy of two different doses of argatroban in sequential therapy is similar,it does not increase the risk of hemorrhage,making it worthy of clinical promotion.关键词
急性脑梗死/阿替普酶/阿加曲班/静脉溶栓/序贯治疗Key words
Acute cerebral infarction/Alteplase/Argatroban/Intravenous thrombolysis/Sequential therapy分类
医药卫生引用本文复制引用
XIAO Kai-min,CHEN Hong-mei,LIU Fu-qiang,XIONG Wei-rong,HU Wei-hua,HE Rong-xin,ZHONG Liang,XIAO Zu-feng..阿替普酶静脉溶栓联合阿加曲班序贯治疗急性脑梗死患者的有效性与安全性研究[J].赣南医科大学学报,2025,45(11):1050-1055,6.基金项目
江西省卫生健康委员会科技计划项目(编号:20212371) （编号:20212371）
