阿加曲班联合双抗治疗穿支动脉病变型脑梗死的疗效及安全性评价

目的观察阿加曲班联合阿司匹林+氯吡格雷治疗穿支动脉病变型脑梗死的临床疗效及安全性。方法选取2014-02—2020-02太原市中心医院神经内科收治的诊断为穿支动脉病变型脑梗死患者78例。按随机原则分为常规组(n=39)和研究组(n=39),常规组给予阿司匹林联合氯吡格雷药物治疗,研究组在常规药物治疗基础上加用阿加曲班注射液10 mg,2次/d,疗程2周。2组均双抗3周后改为单抗阿司匹林长期服用。观察治疗前及治疗7 d和14 d后美国国立卫生研究院卒中量表(NIHSS)评分及3个月后改良的Rankin量表(mRS)评分,记录相关出血事件。结果研究组与常规组治疗前NIHSS评分比较,差异无统计学意义(P>0.05)。研究组治疗7 d、14 d后NIHSS评分较治疗前显著降低(P<0.05),而常规组治疗14 d后才显示出明显改善(P<0.05);治疗后研究组NIHSS评分显著低于常规组,差异有统计学意义(P<0.05)。出血事件发生率研究组10.25%,常规组7.69%,2组比较差异无统计学意义(P>0.05)。治疗3个月后研究组临床总有效率92.30%,显著高于常规组的79.48%,2组比较差异有统计学意义(P<0.05)。结论阿加曲班可明显改善穿支动脉型脑梗死急性期的神经功能恶化,并改善远期预后,且不增加出血风险。

Clinical efficacy and safety evaluation of agaltreban combined with dual antiplatelet therapy for branch atherous cerebral infarction

Objective To observe the clinical efficacy and safety of agtreban combined with aspirin and clopidogrel in the treat?ment of Branch atheromatous cerebral infarction.Methods Totally 78 patients with perforator artery lesion type cerebral infarction admit?ted to the Department of Neurology of Taiyuan Central Hospital from February 2014 to February 2020 were selected.The patients were ran?domly divided into the conventional group(n=39)and the study group(n=39),and the conventional group was given aspirin combined with clopidogrel.The study group was treated with agtreban injection(10mg,twice a day)on the basis of conventional drug therapy for 2 weeks.Both groups were given monoclonal antibody aspirin for a long time after 3 weeks.The scores of the National Institutes of Health stroke scale(NIHSS)and the modified Rankin Scale(mRS)3 months later were observed before treatment,7 days and 14 days after treatment.Record related bleeding events.Results There was no statistically significant difference in NIHSS score between the study group and the conventional group before treatment(P>0.05).The NIHSS score in the study group was significantly decreased after 7 and 14 days of treatment compared with that before treatment(P<0.05),while the NIHSS score in the conventional group was significantly im?proved after 14 days of treatment(P<0.05).The NIHSS score in the treatment group was significantly lower than that in the conventional group,and the difference was statistically significant(P<0.05).The incidence of bleeding events was 10.25%in the study group and 7.69%in the conventional group,and there was no statistical difference between the two groups.After 3 months of treatment,the total clin?ical response rate of the study group was 92.30%,significantly higher than that of the conventional group(79.48%),and the difference between the two groups was statistically significant(P<0.05).Conclusion Agtrebanate can significantly improve the deterioration of nerve function in the acute phase of Branch atheromatous cerebral in?farction and improve the long-term prognosis without increasing the risk of bleeding.