阿加曲班联合阿替普酶对急性脑梗死患者血流动力学及血清脑钠肽、C反应蛋白、同型半胱氨酸水平的影响

目的 观察阿加曲班联合阿替普酶治疗对急性脑梗死患者血流动力学及血清脑钠肽(BNP)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)水平的影响.方法 将急性脑梗死患者100例,按照随机数字表法分为观察组和对照组,每组50例.两组均给予常规的溶栓、抗血小板、吸氧、对症支持等治疗,并给予阿替普酶静脉溶栓治疗,观察组患者在此基础上给予阿加曲班静脉滴注治疗,疗程均为7 d.观察两组患者治疗前后神经功能、全血黏度、红细胞压积、红细胞聚集指数、血清BNP、CRP、Hcy水平及生活质量情况.结果 治疗后观察组治疗有效率为96.0%(41/50),高于对照组的82.0%(48/50)(P<0.05);美国国立卫生研究院卒中量表(NIHSS)得分、全血黏度、红细胞压积、红细胞聚集指数、血清BNP、CRP、Hcy水平均低于对照组(P<0.05).两组治疗后3个月日常生活能力量表(ADL)得分均明显高于治疗前,并且观察组得分高于对照组(P<0.05).结论 阿替普酶加用阿加曲班治疗急性脑梗死可提高治疗效果,改善患者血流动力学、血清BNP、CRP、Hcy水平,提高患者生活质量,且具有良好的安全性.

Effects of argatroban combined with alteplase on hemodynamics and serum levels of brain nutriuretic peptide,C-reactive protein and homocysteine in patients with acute cerebral infarction

Objective To observe the effects of argatroban combined with alteplase on hemodynamics and serum levels of brain natriuretic peptide(BNP),C-reactive protein(CRP) and homocysteine(Hcy) in patients with acute cerebral infarction.Methods One hundred patients with acute cerebral infarction were divided into observation group and control group according to random number table,with 50 cases in each group.Both groups were given regular thrombolysis,antiplatelet,oxygen inhalation,symptomatic treatment and intravenous thrombolysis with alteplase for 7 days,meanwhile,the observation group was given intravenous drip with argatroban additionally for 7 days.The neurological function,whole blood viscosity,hematocrit,erythrocyte aggregation index,serum levels of BNP,CRP and Hcy,and quality of life before and after treatment were observed in the two groups.Results After treatment,the effective rates of the observation group and the control group were 96.0%(41/50) and 82.0%(48/50) respectively.The clinical efficacy of the observation group was better than that of control group(P<0.05).After treatment,the observation group obtained lower National Institutes of Health Stroke Scale(NIHSS) score,lower whole blood viscosity,lower hematocrit,lower erythrocyte aggregation index,lower serum levels of BNP,CRP and Hcy compared to the control group(P<0.05).The Activity of Daily Living Scale(ADL) score increased significantly in both groups after 3 months of treatment compared to the pre-treatment,and the ADL score in the observation group was higher than the score in the control group(P<0.05).Conclusion Argatroban combined with alteplase can improve the therapeutic efficacy,patients′ hemodynamic parameters,serum levels of BNP,CRP and Hcy as well as patients′ quality of life in the treatment of acute cerebral infarction,and it owns good safety.