摘要
目的探讨双抗血小板联合阿加曲班治疗超时间窗急性缺血性脑卒中(acute ischemic stroke,AIS)的临床价值。方法选取2021年2月至2024年2月安丘市人民医院收治的160例超时间窗AIS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,每组80例。对照组采用常规双抗血小板治疗,观察组在对照组的基础上联合阿加曲班治疗。比较两组临床疗效、血清细胞因子水平、认知功能、神经功能、病灶体积、生活自理能力、不良反应发生情况及生命质量。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清血管内皮生长因子、正五聚蛋白3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)。治疗后,两组简易智力状态检查量表(mini-mental state examination,MMSE)评分均高于治疗前,美国国立卫生研究院脑卒中量表(National Institutes of Health stroke scale,NIHSS)评分均低于治疗前,病灶体积均小于治疗前,且观察组MMSE评分高于对照组,NIHSS评分低于对照组,病灶体积小于对照组,差异有统计学意义(P<0.05)。治疗后,两组Barthel指数、功能独立性评估评分均高于治疗前,且观察组高于对照组,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。治疗后,两组生理功能、活力、躯体疼痛及社会功能评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论针对超时间窗AIS患者应用双抗血小板联合阿加曲班治疗,能增强患者的治疗效果,降低炎症因子水平,减小病灶体积,改善认知功能和神经功能,提高患者日常生活能力,且用药安全。
Objective To explore the clinical value of dual antiplatelet therapy combined with argatroban in the treatment of acute ischemic stroke(AIS)patients beyond the time window.Methods 160 AIS patients who beyond the time window in Anqiu People's Hospital from February 2021 to February 2024 were selected as the research subjects,and they were divided into the control group and the observation group using the random number table method,with 80 cases in each group.The control group received conventional dual antiplatelet therapy,while the observation group received combined treatment with argatroban on the basis of the control group.The clinical efficacy,serum cytokine levels,cognitive function,neurological function,lesion volume,self-care ability,occurrence of adverse reactions and quality of life were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of serum vascular endothelial growth factor and pentameric protein 3 of the two groups were lower than those before the treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of the mini-mental state examination(MMSE)of the two groups were higher than those before the treatment,and the National Institutes of Health stroke scale(NIHSS)score were lower than that before treatment,the lesion volume were smaller than that before treatment,and the MMSE score in the observation group was higher than that in the control group,the NIHSS score was lower than that in the control group,and the lesion volume was smaller than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the Barthel index and functional independence assessment scores of the two groups were higher than those before treatment,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups.After the treatment,the scores of physiological function,vitality,physical pain and social function of the two groups were higher than those before treatment,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05).Conclusion The application of dual antiplatelet therapy combined with argatroban for AIS patients beyond the time window can effectively improve the treatment effect,reduce inflammatory factor levels,decrease lesion volume,improve cognitive and neurological function,enhance patients'daily living ability,and ensure medication safety.
作者
李萌生
宋立华
韩爱云
王炎强
徐永婵
LI Mengsheng;SONG Lihua;HAN Aiyun;WANG Yanqiang;XU Yongchan(Department of Neurology,Anqiu People's Hospital,Weifang,Shandong,262100,China;Department of NeurologyⅡ,Affiliated Hospital of Shandong Second Medical University,Weifang,Shandong,261031,China)
出处
《当代医学》
2025年第2期1-5,共5页
Contemporary Medicine
关键词
超时间窗
急性缺血性脑卒中
双抗血小板
阿加曲班
Beyond the time window
Acute ischemic stroke
Dual antiplatelet therapy
Argatroban
