Clinical benefit of argatroban combined with aspirin in the treatment of acute cerebral infarction
Objective To investigate the therapeutic role of argatroban combined with aspirin in patients with acute cerebral infarction based on clinical scores,vascular endothelial function and other indicators.Methods Prospectively selected 108 patients with acute cerebral infarction admitted to Cangzhou City Central Hospital from June 2022 to November 2023 as the study subjects,the patients were divided into 54 cases each in the control group and the treatment group according to the method of randomized numerical table,and the former was given aspirin tablets for simple treatment,and the latter was given aspirin tablets combined with argatroban injection for a period of 1 week.Clinical scores,vascular endothelial function,lipoprotein-associated phospholipid A2(Lp-PLA2),matrix metalloproteinase-9(MMP-9),and tumor necrosis factor-α(TNF-α)(before and 1 week of treatment)and safety(during treatment)were compared between the two groups.Results The National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS)scores,endothelin-1,Lp-PLA2,MMP-9,and TNF-α in the treatment group were lower than those in the control group after 1 week of treatment[(9.12±3.10)points vs.(16.30±2.92)points,(2.04±0.10)points vs.(4.45±0.37)points,(45.25±4.46)ng/L vs.(56.70±5.87)ng/L,(4.50±0.22)pg/mL vs.(11.09±1.15)pg/mL,(110.27±10.70)μg/L vs.(169.45±19.10)μg/L,(2.02±0.15)µg/L vs.(4.59±0.30)µg/L],with statistically significant differences(t=12.389,46.206,11.413,41.360,19.864,56.306,P＜0.05);modified Barthel index(MBI),nitric oxide(NO),vascular endothelial growth factor(VEGF),endothelial dependent vasodilatory function(FMD)were higher in the control group[(75.14±6.22)points vs.(60.90±5.77)points,(69.01±12.20)μmol/L vs.(54.79±11.59)μmol/L,(392.09±61.88)pg/ml vs.(350.03±52.67)pg/ml,(15.70±2.15)％vs.(10.21±1.16)％],the differences were statistically significant(t=12.334,6.210,3.804,16.544,P＜0.05).There was no difference in the safety comparison between the two groups(P＞0.05).Conclusion Patients with acute cerebral infarction were treated with argatroban in combination with aspirin for significant improvement of their symptoms with a favorable safety profile,the mechanism of which may be related to the regulation of vascular endothelial function and serum cytokine levels.
Acute cerebral infarctionArgatrobanAspirinVascular endothelial function
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