阿加曲班联合双抗血小板治疗对急性后循环缺血性脑卒中的作用
Effect of argatroban combined with dual-antibody therapy on acute posterior circulation ischemic stroke
李伟 1王瑾 2李麒 1李雪静1
作者信息
- 1. 廊坊市第四人民医院神经内一科,廊坊 065700
- 2. 廊坊市第四人民医院中医康复科,廊坊 065700
- 折叠
摘要
目的 探究阿加曲班联合双抗血小板治疗对急性后循环缺血性脑卒中(aPCI)患者病情控制及出血事件影响.方法 选取廊坊市第四人民医院2020年12月至2023年9月接受相应治疗的aPCI患者98例,通过随机数字表法分为观察和对照组各49例,对照组采用双抗血小板治疗,观察组在对照组的基础上加用阿加曲班,对比治疗2周后改良Rankin量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)、巴氏指数量表(BI)评分、凝血功能及出血事件发生的情况.结果 治疗后观察组NIHSS评分为(2.26±0.78)分低于对照组(3.65±1.03)分(t=7.531,P<0.05),治疗后观察组mRS评分≤2分的患者比例为53.06%(26/49)高于对照组32.65%(16/49)(χ2=4.167,P<0.05),BI评分为(81.33±12.36)分高于对照组(68.45±12.02)分(t=5.229,P<0.05).治疗后观察组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)[分别为(34.52±4.68)s、(13.05±2.88)s],对照组为[(33.38±4.23)s、(12.13±2.40)s],两组比较差异无统计学意义(t=1.265、1.718,P=0.209、0.089);治疗后观察组纤维蛋白原、D-二聚体水平[分别为(3.02±1.08)g·L-1、(0.36±0.11)mg·L-1]低于对照组[(3.58±1.63)g·L-1、(0.70±0.21)mg·L-1](t=2.005、10.039,均P<0.05).在出血事件发生率方面,观察组为28.57%(14/49),对照组为16.33%(8/49),两组比较差异无统计学意义(χ2=2.110,P=0.146).结论 阿加曲班联合双抗血小板治疗能够有效控制aPCI患者病情,未增加出血风险,安全性可控.
Abstract
Objective To explore the effect of argatroban combined with dual-antibody therapy on disease control and bleeding events in patients with acute posterior circulation ischemic stroke(aPCI).Methods A total of 98 aPCI patients treated in Langfang Fourth People's Hospital from December 2020 to September 2023 were enrolled in this study and assigned into two groups using random number table method,with 49 in each group.The patients in the control group were treated with dual anti-bacterial drugs while those in the observation group with dual anti-bacterial drugs plus argatroban for 2 weeks.Then the National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale score,the Bartholin Index score,coagulation and bleeding events were compared between the two groups.Results The NIHSS score in the observation group was lower than that in the control((2.26±0.78)vs(3.65±1.03),t=7.531,P<0.05).After treatment,the observation group reported a higher proportion of patients with mRS scores≤2 as compared with the control(53.06%(26/49)vs 32.65%(16/49),χ2=4.167,P<0.05).Additionally,the BI score was significantly higher in the observation group than in the control((81.33±12.36)points vs(68.45±12.02)points,t=5.229,P<0.05).The activated partial thromboplastin time(APTT)and prothrombin time(PT)of the observation group after autism treatment were(34.52±4.68)s and(13.05±2.88)s,respectively,while those of the control group were(33.38±4.23)s and(12.13±2.40)s,respectively.There was no statistically significant difference between the two groups(t=1.265,1.718,P=0.209,0.089).The levels of fibrinogen and D-dimer in the observation group after treatment were(3.02±1.08)g·L-1 and(0.36±0.11)mg·L-1,respectively and they were lower than those in the control((3.58±1.63)g·L-1,(0.70±0.21)mg·L-1)(t=2.005,10.039,both P<0.05).In terms of the incidence of bleeding events,the observation group was 28.57%(14/49)while the control group was 16.33%(8/49).No statistical difference was found between the two groups(χ2=2.110,P=0.146).Conclusion Argatroban combined with dual-antibody therapy can effectively control the condition of aPCI patients without increasing the risk of bleeding,and the its safety is controllable.
关键词
阿加曲班/双抗血小板治疗/急性后循环缺血性脑卒中/病情控制/出血事件Key words
Argatroban/Dual-antibody therapy/Acute posterior circulation ischemic stroke/Disease control/Bleeding event引用本文复制引用
基金项目
廊坊市科学技术研究与发展计划(2023013207)
出版年
2024
NETL
NSTL
万方数据