阿加曲班联合氯吡格雷治疗急性后循环缺血性脑梗死的疗效观察

目的探究阿加曲班联合氯吡格雷治疗急性后循环缺血性脑梗死的临床疗效。方法选取2015年1月—2017年1月河北省沧州中西医结合医院神经内科收治的急性后循环缺血性脑梗死患者100例,随机分为对照组和治疗组,每组各50例。对照组口服硫酸氢氯吡格雷片,1片/次,1次/d。治疗组在对照组治疗基础上给予阿加曲班注射液,60 mg/d,24 h持续静脉滴注,连续治疗2 d,第三天将剂量改为10 mg/次,2次/d,持续5 d。两组均连续治疗14 d。观察两组的临床疗效,比较两组NIHSS评分、BI指数、m RS评分。结果治疗后,对照组和治疗组的总有效率分别为88.0%、94.0%,两组比较差异有统计学意义(P0.05)。治疗7、14 d,两组患者NIHSS评分均显著降低,BI指数显著升高,同组治疗前后比较差异有统计学意义(P0.05);治疗7、14 d,治疗组NIHSS评分低于对照组,BI指数高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组m RS评分显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论阿加曲班联合氯吡格雷治疗急性后循环缺血性脑梗死具有较好的临床疗效,可降低NIHSS评分和m RS评分,具有一定的临床推广应用价值。

Clinical observation on argatroban combined with clopidogrel in treatment of acute posterior circulation ischemic cerebral infarction

Objective To evaluate the clinical efficacy of argatroban combined with clopidogrel in treatment of acute posterior circulation ischemic cerebral infarction. Methods Patients (100 cases) with acute posterior circulation ischemic cerebral infarction in Neurology Department of Cangzhou Hospital of Integrated TCM-WM Hebei from January, 2015 to January, 2017 were randomly divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were iv administered with Argatroban Injection on the basis of the control group, 60 mg/d for 2 d. On the third day, the dosage should be changed to 10 mg/time, twice daily for 5 d. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS score, BI, mRS score in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 88.0% and 94.0%, respectively, and there was difference between two groups (P < 0.05). On the treatment of 7 and 14 d, NIHSS scores in two groups were decreased, but BI were increased, and the difference was statistically significant in the same group (P < 0.05). On the treatment of 7 and 14 d, NIHSS scores in the treatment group was lower than that in the control group, but BI was higher than that in the control group, and there was difference between two groups (P < 0.05). Conclusion Argatroban combined with clopidogrel has clinical curative effect in treatment of acute posterior circulation ischemic cerebral infarction, can reduce NIHSS score and mRS score, which has a certain clinical application value.