摘要
目的 研究阿加曲班对合并高同型半胱氨酸血症(HHcy)急性脑梗死患者血脂、炎症指标及神经系统功能的影响.方法 选取140例合并HHcy的急性脑梗死患者,随机均分为对照组(常规治疗)和观察组(阿加曲班+常规治疗).分析各组血浆同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、总胆固醇(TC)、甘油三酯(TG)、美国国立卫生研究院卒中量表评分(NIHSS)、日常生活活动能力评分量表(Barthel指数)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)水平.分析治疗前Hcy、hs-CRP、HDLC、LDLC、TC、TG与NIHSS评分和Barthel指数的相关性.结果 与治疗前比较,治疗后对照组和观察组血Hcy、hs-CRP、LDLC及TC均下降,且观察组低于对照组(P＜0.05).对照组PT、APTT于第5天升至正常范围,观察组于第3天即升至正常范围.在入院第2～4天时,观察组PT、APTT均明显高于对照组(P＜0.05),而第6～7天两组PT、APTT比较差异无显著性(P＞0.05).与第1天比较,第7、30、90天两组NIHSS评分均降低,Barthel指数均升高;且观察组较对照组变化更为显著(P＜0.05).血Hcy水平、hs-CRP、LDLC与NIHSS呈正相关,与Barthel指数呈负相关(P＜0.05).结论 阿加曲班可显著降低HHcy急性脑梗死患者血脂、Hcy及炎症水平,改善患者凝血功能,加快神经功能及生活能力恢复.
Abstract
Aim To investigate the impact of argatroban on lipid profiles,inflammatory markers,and neurological function in acute cerebral infarction patients with hyperhomocysteinemia(HHcy).Methods A total of 140 acute cerebral infarction pa-tients with HHcy were selected and randomly divided into two groups,namely the control group(standard treatment)and the observa-tion group(argatroban+standard treatment).We analyzed plasma homocysteine(Hcy),hyper-sensitivity C-reactive protein(hs-CRP),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),total cholesterol(TC),triglycerides(TG),national institutes of health stroke scale(NIHSS)scores,Barthel index scores,prothrombin time(PT),and acti-vated partial thromboplastin time(APTT).We then analyzed the correlation between Hcy,hs-CRP,HDLC,LDLC,TC,TG,NIHSS scores,and Barthel index before treatment.Results Compared with the pre-treatment levels,post-treatment levels of Hcy,hs-CRP,LDLC,and TC were decreased in both groups,with the observation group showing significantly lower levels than the control group(P＜0.05).PT and APTT returned to normal ranges by day 5 in the control group and by day 3 in the observation group.PT and APTT were significantly higher in the observation group than in the control group on days 2-4(P＜0.05),but no significant differ-ences were observed between the two groups on days 6-7(P＞0.05).NIHSS scores were decreased and Barthel index scores were in-creased on days 7,30,and 90 in both groups compared with those on day 1,with more significant improvements in the observation group(P＜0.05).Hey,hs-CRP,and LDLC levels were positively correlated with NIHSS scores and negatively correlated with Barthel index scores(P＜0.05).Conclusion Argatroban significantly reduces lipid levels,Hcy,and inflammation in acute cerebral infarc-tion patients with HHcy,improves coagulation function,and accelerates the recovery of neurological function and daily living activities.
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