摘要
目的探究阿加曲班联合丁苯酞治疗缺血性脑卒中(CIS)患者的效果。方法选取2018年5月至2020年5月本院收治的80例CIS患者作为研究对象,按照随机数字表法分为对照组与观察组,各40例。两组均接受常规对症治疗,对照组在常规治疗基础上给予阿加曲班治疗,观察组在对照组治疗基础上给予丁苯酞软胶囊治疗。比较两组临床疗效,治疗前后神经功能与生活能力[美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)、Barthel指数(BI)]、血栓弹力图相关参数[凝血反应时间(R)、血细胞凝集块形成时间(K)、血细胞凝集块形成速率α角、最大血块强度(MA)及MA值后30 min内血凝块溶解百分比(LY30)]、炎症因子指标[肿瘤坏死因子-α(TNF-α)和超敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]及不良反应发生情况。结果观察组治疗总有效率为95.00%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗后,两组NIHSS、mRS评分均低于治疗前,BI评分均高于治疗前,且观察组NIHSS、mRS评分均低于对照组,BI评分高于对照组,差异有统计学意义(P<0.05)。治疗后,两组R、K均长于治疗前,LY30高于治疗前,α角、MA值均小于治疗前,且观察组R、K均长于对照组,LY30高于对照组,α角、MA值均小于对照组,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、hs-CRP、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论阿加曲班联合丁苯酞可有效修复CIS患者神经功能损伤,改善患者凝血功能指标,减轻机体炎症反应,提高其日常生活能力,安全性高,值得临床推广应用。
Objective To explore the application effect of argatroban combined with butylphthalide in the treatment of patients with cerebral ischemic stroke(CIS).Methods 80 patients with CIS admitted to our hospital from May 2018 to May 2020 were selected as the research subjects,they were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.Both groups received conventional symptomatic treatment,the control group was treated with argatroban on the basis of the conventional treatment,and the observation group was treated with butylphthalide soft capsule on the basis of the control group.The clinical efficacy,neurological function and living ability(National Institutes of Health stroke scale[NIHSS],modified Rankin scale[mRS],Barthel index[BI]),thromboelastography related parameters(coagulation reaction time[R],blood clot formation time[K],blood clot formation rateαAngle,maximum blood clot intensity[MA]and the percentage of blood clot dissolution within 30 min after MA value[LY30]),inflammatory factor indexes(tumor necrosis factor-α[TNF-α],highsensitivity C-reactive protein[hs-CRP],interleukin-6[IL-6])before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 95.00%,which was higher than 75.00%in the control group,the difference was statistically significant(P<0.05).After treatment,the scores of NIHSS and mRS of the two groups were lower than those before treatment,and the BI score was higher than that before treatment,and the scores of NIHSS and mRS in the observation group were lower than those in the control group,and the BI score was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the R and K of the two groups were longer than those before treatment,LY30 were higher than those before treatment,andαAngle and MA values were smaller than those before treatment,and the R and K in the observation group were longer than those in the control group,LY30 was higher than that in the control group,αAngle and MAvalues were smaller than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of TNF-α,hs-CRP and IL-6 of the two groups were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Argatroban combined with butylphthalide can effectively repair neurological damage in CIS patients,the coagulation function of patients was improved,reduce the body's inflammatory response,and improve the ability of daily living,with high safety,and is worthy of clinical promotion application.
作者
田琪
于成璐
董雪
TIAN Qi;YU Chenglu;DONG Xue(Department of Neurology,Dandong First Hospital,Dandong,Liaoning,118000,China)
出处
《当代医学》
2023年第10期5-9,共5页
Contemporary Medicine
关键词
阿加曲班
丁苯酞
缺血性脑卒中
氧化应激指标
凝血功能
神经功能
Agatroban
Butylphthalide
Cerebral ischemic stroke
Oxidative stress index
Coagulation function
Neurological function
