The effect of agatroban on ischemic penumbra blood flow in acute cerebral infarction
Objective To observe the effect of agatroban on blood flow in the ischemic penumbra of acute cerebral infarction.Methods This article is a prospective study,with cases included from June 2021 to June 2022.The enrolled 116 patients with acute cerebral infarction were randomly divided into an experimental group(fifty-eight cases)and a conventional group(fifty-eight cases)using a random number table method.The conventional group received basic treatment for acute cerebral infarction,while the experimental group received combined treatment with agatroban.The coagulation function and endothelial function of the two groups before and after treatment were compared.The improvement of hemodynamics in the ischemic penumbra area was observed.All patients were followed up for six months after treatment and the recovery of brain nerve function between the two groups was compared.Results Before treatment,the coagulation function of the two groups was similar(P＞0.05).After treatment,the activated partial thromboplastin time(APTT),prothrombin time(PT),and thrombin time(TT)of the experimental group were(33.2±5.4)s,(12.6±4.2)s,and(26.6±5.3)s,all of which were higher than those of the control group[(30.4±5.2)s,(10.4±3.2)s,and(23.4±5.2)s](P＜0.05).Before treatment,the endothelial function of the two groups of patients was similar(P＞0.05).After treatment,the endothelin-1(ET-1)and nitric oxide(NO)levels in the experimental group were(46±10)ng/L and(54±10)ppb,both lower than those in the conventional group[(51±10)ng/L and(60±10)ppb].The calcitonin gene-related peptide(CGRP)levels in the experimental group were(85±10)ng/L,which were higher than those in the conventional group(80±10)ng/L(P＜0.05).Before treatment,the hemodynamic indicators of the ischemic penumbra in both groups of pa-tients were similar(P＞0.05).After treatment,the cerebral blood flow(CBF)of the ischemic penumbra in the ex-perimental group was(17.4±4.3)ml/(100 g·min),which was higher than that in the conventional group(14.4±4.1)ml/(100 g·min).The mean blood flow passage time(MTT)was(5.2±1.4)s,and the peak time(TTP)was(5.3±1.3)s,both lower than those in the conventional group[(6.7±2.1)s,(6.8±2.1)s](P＜0.05).Before treatment,the brain nerve function of the two groups was similar(P＞0.05).Under different treatment plans,the NIHSS score of the experimental group at the third month of follow-up was(20.4±5.1)points,and the NIHSS score at the sixth month of follow-up was(14.3±4.4)points,both lower than those in the conventional group[(23.4±5.2)points,(17.2±4.3)points].The improved Bathel index(MBI)score of the experimental group in the third month of follow-up was(78±10)points,and the MBI score at the sixth month of follow-up was(87±10)points,both higher than those in the conventional group[(72±10)points and(81±10)points](P＜0.05).Conclusion Agatroban can effectively improve the coagulation function of patients with acute cerebral infarction,alleviate vascular endothelial damage,promote blood flow in the ischemic penumbra area,and have a positive effect on the recovery of brain nerve function.
Brain infarctionAgatrobanHemodynamicsIschemic penumbraNeurological function
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