Forced degradation study of argatroban under conditions of hydrolysis(neutral, acidic and alkaline), oxidation,photolysis and thermal stress, as suggested in the ICH Q1 A(R2), was accomplished. The drug showed signifi...Forced degradation study of argatroban under conditions of hydrolysis(neutral, acidic and alkaline), oxidation,photolysis and thermal stress, as suggested in the ICH Q1 A(R2), was accomplished. The drug showed significant degradation under hydrolysis(acidic, alkaline) and oxidation(peroxide stress) conditions. The drug remained stable under thermal and photolytic stress conditions. In total, seven novel degradation products(DP-1 to DP-7) were found under diverse conditions, which were not reported earlier. The chemical structures of these degradation products were characterized by ~1H NMR,^(13)C NMR, 2 D NMR, Q-TOF-MSnand IR spectral analysis and the proposed degradation products structures were further confirmed by the individual synthesis.展开更多
BACKGROUND Argatroban is a novel direct thrombin inhibitor that has been used for treatment of acute ischemic stroke(AIS).To our knowledge,no systematic analysis has assessed the efficacy and safety of argatroban for ...BACKGROUND Argatroban is a novel direct thrombin inhibitor that has been used for treatment of acute ischemic stroke(AIS).To our knowledge,no systematic analysis has assessed the efficacy and safety of argatroban for treatment of AIS.AIM To evaluate the efficacy and safety of argatroban for treatment of AIS.METHODS Cochrane Library,Medline,PubMed,and Web of Science were searched to retrieve all studies associated with argatroban and AIS.Effective rate,adverse events rate,and 95%confidence intervals were calculated and pooled using metaanalysis methodology.RESULTS We only found four randomized controlled studies,comprising 354 cases with 213 in the argatroban group and 141 in the control group.Great heterogeneity was found in the four studies(c2=11.44,I2=74%,P=0.01).Subgroup analysis could not be performed because of the absence of detailed data.The two most recent studies showed acceptable heterogeneity(c2=1.56,I2=36%,P=0.21).Our analysis showed that argatroban was not more effective than the control therapy in the acute phase of ischemic stroke(Z=0.01,P=0.99).Argatroban did not increase the risk of bleeding compared with the control group(c2=0.37,I2=0%,P=0.54,Z=0.80,P=0.42).CONCLUSION Patients with AIS might not benefit from argatroban and combination therapy with argatroban does not increase bleeding tendency.展开更多
Argatroban is a synthetic thrombin inhibitor approved by U.S.Food and Drug Administration for the treatment of thrombosis.However,whether it plays a role in the repair of spinal cord injury is unknown.In this study,we...Argatroban is a synthetic thrombin inhibitor approved by U.S.Food and Drug Administration for the treatment of thrombosis.However,whether it plays a role in the repair of spinal cord injury is unknown.In this study,we established a rat model of T10 moderate spinal cord injury using an NYU Impactor ModerⅢand performed intraperitoneal injection of argatroban for 3 consecutive days.Our results showed that argatroban effectively promoted neurological function recovery after spinal cord injury and decreased thrombin expression and activity in the local injured spinal cord.RNA sequencing transcriptomic analysis revealed that the differentially expressed genes in the argatroban-treated group were enriched in the JAK2/STAT3 pathway,which is involved in astrogliosis and glial scar formation.Western blotting and immunofluorescence results showed that argatroban downregulated the expression of the thrombin receptor PAR1 in the injured spinal cord and the JAK2/STAT3 signal pathway.Argatroban also inhibited the activation and proliferation of astrocytes and reduced glial scar formation in the spinal cord.Taken together,these findings suggest that argatroban may inhibit astrogliosis by inhibiting the thrombin-mediated PAR1/JAK2/STAT3 signal pathway,thereby promoting the recovery of neurological function after spinal cord injury.展开更多
Objective: Analyze the effect of argatroban on neurological function in patients with acute cerebral infarction and explore its possible mechanisms. Methods: From August 2015 to August 2017, 140 patients with acute ce...Objective: Analyze the effect of argatroban on neurological function in patients with acute cerebral infarction and explore its possible mechanisms. Methods: From August 2015 to August 2017, 140 patients with acute cerebral infarction who were admitted to the Department of Neurology in our hospital were divided into a control group and an observation group according to the lottery method, with 70 cases in each group. Patients in the conventional group received routine treatment. Patients in the treatment group received routine treatment plus argatroban. The changes of neurological function, coagulation function and inflammatory factors were observed in the two groups. Result: Before treatment, there were no significant differences in neurological function parameters, coagulation function indexes and inflammatory factors between the two groups. After treatment, the neurological function indexes NT-proBNP, NPY and S-100β levels, coagulation function index FIB level, inflammatory factor indicators MMP-9, Lp-PLA2 and Hcy, vascular endothelial function index ET levels decreased, coagulation Functional indicators PT, TT and APTT are both elevated, and NO and CGRP levels are elevated. The levels of NT-proBNP, NPY and S-100β, FIB level, MMP-9, Lp-PLA2 and Hcy, ET levels in the treatment group were lower than those in the conventional group, while the levels of PT, TT and APTT levels, and NO and CGRP levels were higher than the conventional group. Conclusion: Argatroban treatment can significantly improve neurological function in patients with acute cerebral infarction. The possible mechanism is to improve coagulation function, vascular endothelial function and relieve inflammatory stress response.展开更多
Argatroban is an intravenous DTI （direct synthetic thrombin inhibitor） that is not routinely used for anticoagulation; thus, expertise surrounding its use is very limited. Therefore, this case reviews an unusually h...Argatroban is an intravenous DTI （direct synthetic thrombin inhibitor） that is not routinely used for anticoagulation; thus, expertise surrounding its use is very limited. Therefore, this case reviews an unusually high argatroban infusion rate, which was needed to prevent further emboli formation in a patient. In this case, a 61-year-old Caucasian male patient exhibited heparin resistance during an intraoperative vascular procedure as measured by activated clotting time and PTT （partial thromboplastin time）. The patient had multiple occlusions in his right lower extremities and underwent embolectomies of the right popliteal and posterior tibial arteries. The clinical pharmacist was consulted to manage the argatroban infusion once heparin was discontinued. The therapeutic window required a PTr of 1.5-3 times the patient baseline （35-75 s）. The patient was reported to be 89 kg with a baseline PTT of 24.7 s and INR （international normalized ratio） of 0.98. The starting dose ofargatroban was initiated by the pharmacist at 2 mcg/kg/min （10.7 mL/h） as the patient did not have hepatic failure or sepsis. The patient was maintained on argatroban in the therapeutic PTT window for more than 72 h; however, frequent and aggressive dose increases, to a final rate of 7.5 mcg/kg/min （40 mL/h）, were needed to maintain the therapeutic PTT level. From the case, the cause of heparin resistance still has not been determined despite a hematologic work-up; however, this patient required an unusually high infusion rate of argatroban to maintain a therapeutic PTT during the hospital course before being changed to an anticoagulation regimen for discharge.展开更多
Objective: to explore the feasibility and effectiveness of butylphthalide sodium chloride combined with argatroban in the clinical treatment of patients with ischemic stroke. Methods: the study was conducted in a retr...Objective: to explore the feasibility and effectiveness of butylphthalide sodium chloride combined with argatroban in the clinical treatment of patients with ischemic stroke. Methods: the study was conducted in a retrospective way. The period of case inclusion ranged from April 2021 to May 2022. Seventy patients with ischemic stroke in our hospital were selected and randomly divided into standardized groups. Among them, 33 cases were included in the control group and given conventional treatment with butylphthalide sodium chloride, while 37 cases in the observation group were given butylphthalide sodium chloride combined with argatroban;The total effective rate, neurological function, daily living ability, cognitive function, limb motor function, serum lipoprotein phospholipase A2(LP-PLA2), fibrinogen (FIB) and other indicators were observed and compared between the two groups. Results: (1) through the evaluation of the therapeutic effect of all subjects, the total therapeutic effect of the observation group was 97.2%, which was significantly better than that of the control group (P<0.05). (2) After receiving all the treatments, the life activities and the degree of nerve defect of the two groups of patients have changed significantly, and the difference is greater than that of the control group, and the change in the observation group is more significant (P < 0.05). (3) The cognitive function and limb movement function of the two groups of patients were improved after receiving all treatments. Compared with the control group, the cognitive function and limb movement function of the observation group were significantly higher than those of the control group(P<0.05). (4) Before the implementation of the treatment, the FIB and LP-PLA2 indexes of the two groups of patients were evaluated and compared, with no significant difference in level (P>0.05). after all the treatment, the FIB and LP-PLA2 values of the two groups of patients were evaluated, with each index showing a decrease, and each index of the observation group was at a lower level (P<0.05). Conclusion: the combination of butylphthalide sodium chloride and argatroban has a significant effect in the treatment of ischemic stroke, which can improve the neurological function, daily living ability and cognitive function of patients.展开更多
Objective:This study compared the clinical efficacy and safety of argatroban and alteplase in the treatment of acute cerebral infarction.Methods:This study retrospectively analyzed 131 patients admitted for acute cere...Objective:This study compared the clinical efficacy and safety of argatroban and alteplase in the treatment of acute cerebral infarction.Methods:This study retrospectively analyzed 131 patients admitted for acute cerebral infarction within 48 h of onset from 1 December 2018 to 1 May 2021.The patients were divided according to treatment(i.e.,the argatroban and alteplase groups).The National Institutes of Health Stroke Scale(NIHSS)scores(before treatment,at 24 h,and at 3,7,and 14 days),14-day response rate,3-month modified Rankin Scale score(mRS),activities of daily living(ADL)score,prognosis,and adverse events during treatment were compared.Results:Sixty-two and 69 patients were enrolled in the alteplase and argatroban groups,respectively,and both had comparable baseline data.The NIHSS scores of the alteplase group decreased significantly before and after treatment(24 h and at 3,7,and 14 days),whereas those of the alteplase group decreased most rapidly after 24 h of administration.The argatroban group showed no significant changes in NIHSS score in the first 7 days after treatment until day 14,at which it significantly decreased.Statistically significant differences between the two groups were observed in four points(P<0.05).The 14-day effectivity rate of alteplase was significantly higher than that of argatroban(83.8%vs.65.2%;χ^(2)?131;P?0.001).The 3-month mRS,ADL and pre-treatment comparisons were statistically significant in the two groups(P<0.05),while the inter-group comparison was not statistically significant(P>0.05).Furthermore,the outcomes at 3 months after treatment in both groups did not vary significantly(alteplase vs.argatroban:48/62 vs.51/69;χ^(2)?0.217;P?0.641).Adverse events during treatment included gingival bleeding(two patients),positive fecal occult blood(two patients),and minor intracranial blood ooze(one patient)in the alteplase group,whereas no adverse events(e.g.,bleeding and shock)were noted in the argatroban group.Conclusion:The short-term efficacy of argatroban in improving neurological function in patients with acute cerebral infarction was significantly lower than that of alteplase.However,the long-term efficacy at 3 months of treatment was comparably significant to that of alteplase with fewer adverse events.展开更多
目的探讨注射用己酮可可碱联合阿加曲班治疗大动脉粥样硬化型急性缺血性脑卒中(large artery atherosclerotic acute ischemic stroke,LAA-AIS)伴阿司匹林抵抗的临床疗效及安全性。方法选择2021年1月—2023年12月收治的106例LAA-AIS伴...目的探讨注射用己酮可可碱联合阿加曲班治疗大动脉粥样硬化型急性缺血性脑卒中(large artery atherosclerotic acute ischemic stroke,LAA-AIS)伴阿司匹林抵抗的临床疗效及安全性。方法选择2021年1月—2023年12月收治的106例LAA-AIS伴阿司匹林抵抗患者作为研究对象,用随机数字表法分为观察组和对照组,每组53例。观察组给予注射用己酮可可碱联合阿加曲班治疗,对照组单用阿加曲班治疗。治疗结束后对2组的疗效进行评估。治疗前后对2组患者进行相关功能量表[美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、简易精神状态检查(Mini-Mental State Examination,MMSE)、改良Barthel指数(Modified Barthel Index,MBI)]评定;血栓弹力图[凝血反应时间(reaction time,R值)、血凝块形成时间(kinetics of clot formation,K值)、血凝块形成速率(angle of clot formation,Angle)、血凝块最大强度(maximum amplitude,MA)]检查;炎症相关指标[红细胞分布宽度变异系数(red cell distribution width-coefficient of variation,RDW-CV)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]检测;氧化应激指标[丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)]检测;比较2组不良反应的发生情况。结果观察组的总有效率显著高于对照组(90.57%vs.75.47%,P<0.05)。2组治疗后的NIHSS评分均显著下降(P<0.05),MMSE、MBI评分均显著升高(P<0.05),且均以观察组的变化更明显(P<0.05)。治疗后,2组的R值、K值均显著上升(P<0.05),Angle、MA均显著降低(P<0.05),且均以观察组的变化更明显(P<0.05)。治疗后,2组的RDW-CV、NLR、PLR、IL-6、TNF-α均显著降低(P<0.05),且观察组降低得更明显(P<0.001)。治疗后,2组的血清MDA含量均显著降低(P<0.05),血清SOD、GSH-Px活性均显著升高(P<0.05),且均以观察组的变化更明显(P<0.05)。2组不良反应发生率(11.32%vs.5.66%)比较差异无统计学意义(P>0.05)。结论注射用己酮可可碱联合阿加曲班治疗LAA-AIS伴阿司匹林抵抗能有效改善凝血功能,减轻炎症反应和氧化应激反应,促进患者神经功能和认知功能的恢复。展开更多
文摘Forced degradation study of argatroban under conditions of hydrolysis(neutral, acidic and alkaline), oxidation,photolysis and thermal stress, as suggested in the ICH Q1 A(R2), was accomplished. The drug showed significant degradation under hydrolysis(acidic, alkaline) and oxidation(peroxide stress) conditions. The drug remained stable under thermal and photolytic stress conditions. In total, seven novel degradation products(DP-1 to DP-7) were found under diverse conditions, which were not reported earlier. The chemical structures of these degradation products were characterized by ~1H NMR,^(13)C NMR, 2 D NMR, Q-TOF-MSnand IR spectral analysis and the proposed degradation products structures were further confirmed by the individual synthesis.
文摘BACKGROUND Argatroban is a novel direct thrombin inhibitor that has been used for treatment of acute ischemic stroke(AIS).To our knowledge,no systematic analysis has assessed the efficacy and safety of argatroban for treatment of AIS.AIM To evaluate the efficacy and safety of argatroban for treatment of AIS.METHODS Cochrane Library,Medline,PubMed,and Web of Science were searched to retrieve all studies associated with argatroban and AIS.Effective rate,adverse events rate,and 95%confidence intervals were calculated and pooled using metaanalysis methodology.RESULTS We only found four randomized controlled studies,comprising 354 cases with 213 in the argatroban group and 141 in the control group.Great heterogeneity was found in the four studies(c2=11.44,I2=74%,P=0.01).Subgroup analysis could not be performed because of the absence of detailed data.The two most recent studies showed acceptable heterogeneity(c2=1.56,I2=36%,P=0.21).Our analysis showed that argatroban was not more effective than the control therapy in the acute phase of ischemic stroke(Z=0.01,P=0.99).Argatroban did not increase the risk of bleeding compared with the control group(c2=0.37,I2=0%,P=0.54,Z=0.80,P=0.42).CONCLUSION Patients with AIS might not benefit from argatroban and combination therapy with argatroban does not increase bleeding tendency.
基金supported by the Key Project of the National Natural Science Foundation of China,No.81930070(to SF)the National Natural Science Foundation of China,No.81972074(to XY)the Key Program of Natural Science Foundation of Tianjin,No.19JCZDJC34900(to XY)。
文摘Argatroban is a synthetic thrombin inhibitor approved by U.S.Food and Drug Administration for the treatment of thrombosis.However,whether it plays a role in the repair of spinal cord injury is unknown.In this study,we established a rat model of T10 moderate spinal cord injury using an NYU Impactor ModerⅢand performed intraperitoneal injection of argatroban for 3 consecutive days.Our results showed that argatroban effectively promoted neurological function recovery after spinal cord injury and decreased thrombin expression and activity in the local injured spinal cord.RNA sequencing transcriptomic analysis revealed that the differentially expressed genes in the argatroban-treated group were enriched in the JAK2/STAT3 pathway,which is involved in astrogliosis and glial scar formation.Western blotting and immunofluorescence results showed that argatroban downregulated the expression of the thrombin receptor PAR1 in the injured spinal cord and the JAK2/STAT3 signal pathway.Argatroban also inhibited the activation and proliferation of astrocytes and reduced glial scar formation in the spinal cord.Taken together,these findings suggest that argatroban may inhibit astrogliosis by inhibiting the thrombin-mediated PAR1/JAK2/STAT3 signal pathway,thereby promoting the recovery of neurological function after spinal cord injury.
文摘Objective: Analyze the effect of argatroban on neurological function in patients with acute cerebral infarction and explore its possible mechanisms. Methods: From August 2015 to August 2017, 140 patients with acute cerebral infarction who were admitted to the Department of Neurology in our hospital were divided into a control group and an observation group according to the lottery method, with 70 cases in each group. Patients in the conventional group received routine treatment. Patients in the treatment group received routine treatment plus argatroban. The changes of neurological function, coagulation function and inflammatory factors were observed in the two groups. Result: Before treatment, there were no significant differences in neurological function parameters, coagulation function indexes and inflammatory factors between the two groups. After treatment, the neurological function indexes NT-proBNP, NPY and S-100β levels, coagulation function index FIB level, inflammatory factor indicators MMP-9, Lp-PLA2 and Hcy, vascular endothelial function index ET levels decreased, coagulation Functional indicators PT, TT and APTT are both elevated, and NO and CGRP levels are elevated. The levels of NT-proBNP, NPY and S-100β, FIB level, MMP-9, Lp-PLA2 and Hcy, ET levels in the treatment group were lower than those in the conventional group, while the levels of PT, TT and APTT levels, and NO and CGRP levels were higher than the conventional group. Conclusion: Argatroban treatment can significantly improve neurological function in patients with acute cerebral infarction. The possible mechanism is to improve coagulation function, vascular endothelial function and relieve inflammatory stress response.
文摘Argatroban is an intravenous DTI （direct synthetic thrombin inhibitor） that is not routinely used for anticoagulation; thus, expertise surrounding its use is very limited. Therefore, this case reviews an unusually high argatroban infusion rate, which was needed to prevent further emboli formation in a patient. In this case, a 61-year-old Caucasian male patient exhibited heparin resistance during an intraoperative vascular procedure as measured by activated clotting time and PTT （partial thromboplastin time）. The patient had multiple occlusions in his right lower extremities and underwent embolectomies of the right popliteal and posterior tibial arteries. The clinical pharmacist was consulted to manage the argatroban infusion once heparin was discontinued. The therapeutic window required a PTr of 1.5-3 times the patient baseline （35-75 s）. The patient was reported to be 89 kg with a baseline PTT of 24.7 s and INR （international normalized ratio） of 0.98. The starting dose ofargatroban was initiated by the pharmacist at 2 mcg/kg/min （10.7 mL/h） as the patient did not have hepatic failure or sepsis. The patient was maintained on argatroban in the therapeutic PTT window for more than 72 h; however, frequent and aggressive dose increases, to a final rate of 7.5 mcg/kg/min （40 mL/h）, were needed to maintain the therapeutic PTT level. From the case, the cause of heparin resistance still has not been determined despite a hematologic work-up; however, this patient required an unusually high infusion rate of argatroban to maintain a therapeutic PTT during the hospital course before being changed to an anticoagulation regimen for discharge.
文摘Objective: to explore the feasibility and effectiveness of butylphthalide sodium chloride combined with argatroban in the clinical treatment of patients with ischemic stroke. Methods: the study was conducted in a retrospective way. The period of case inclusion ranged from April 2021 to May 2022. Seventy patients with ischemic stroke in our hospital were selected and randomly divided into standardized groups. Among them, 33 cases were included in the control group and given conventional treatment with butylphthalide sodium chloride, while 37 cases in the observation group were given butylphthalide sodium chloride combined with argatroban;The total effective rate, neurological function, daily living ability, cognitive function, limb motor function, serum lipoprotein phospholipase A2(LP-PLA2), fibrinogen (FIB) and other indicators were observed and compared between the two groups. Results: (1) through the evaluation of the therapeutic effect of all subjects, the total therapeutic effect of the observation group was 97.2%, which was significantly better than that of the control group (P<0.05). (2) After receiving all the treatments, the life activities and the degree of nerve defect of the two groups of patients have changed significantly, and the difference is greater than that of the control group, and the change in the observation group is more significant (P < 0.05). (3) The cognitive function and limb movement function of the two groups of patients were improved after receiving all treatments. Compared with the control group, the cognitive function and limb movement function of the observation group were significantly higher than those of the control group(P<0.05). (4) Before the implementation of the treatment, the FIB and LP-PLA2 indexes of the two groups of patients were evaluated and compared, with no significant difference in level (P>0.05). after all the treatment, the FIB and LP-PLA2 values of the two groups of patients were evaluated, with each index showing a decrease, and each index of the observation group was at a lower level (P<0.05). Conclusion: the combination of butylphthalide sodium chloride and argatroban has a significant effect in the treatment of ischemic stroke, which can improve the neurological function, daily living ability and cognitive function of patients.
基金supported by High-level talent team construction project of Hebei Provincial Department of Science and Technology(Grant No.199A7759H).
文摘Objective:This study compared the clinical efficacy and safety of argatroban and alteplase in the treatment of acute cerebral infarction.Methods:This study retrospectively analyzed 131 patients admitted for acute cerebral infarction within 48 h of onset from 1 December 2018 to 1 May 2021.The patients were divided according to treatment(i.e.,the argatroban and alteplase groups).The National Institutes of Health Stroke Scale(NIHSS)scores(before treatment,at 24 h,and at 3,7,and 14 days),14-day response rate,3-month modified Rankin Scale score(mRS),activities of daily living(ADL)score,prognosis,and adverse events during treatment were compared.Results:Sixty-two and 69 patients were enrolled in the alteplase and argatroban groups,respectively,and both had comparable baseline data.The NIHSS scores of the alteplase group decreased significantly before and after treatment(24 h and at 3,7,and 14 days),whereas those of the alteplase group decreased most rapidly after 24 h of administration.The argatroban group showed no significant changes in NIHSS score in the first 7 days after treatment until day 14,at which it significantly decreased.Statistically significant differences between the two groups were observed in four points(P<0.05).The 14-day effectivity rate of alteplase was significantly higher than that of argatroban(83.8%vs.65.2%;χ^(2)?131;P?0.001).The 3-month mRS,ADL and pre-treatment comparisons were statistically significant in the two groups(P<0.05),while the inter-group comparison was not statistically significant(P>0.05).Furthermore,the outcomes at 3 months after treatment in both groups did not vary significantly(alteplase vs.argatroban:48/62 vs.51/69;χ^(2)?0.217;P?0.641).Adverse events during treatment included gingival bleeding(two patients),positive fecal occult blood(two patients),and minor intracranial blood ooze(one patient)in the alteplase group,whereas no adverse events(e.g.,bleeding and shock)were noted in the argatroban group.Conclusion:The short-term efficacy of argatroban in improving neurological function in patients with acute cerebral infarction was significantly lower than that of alteplase.However,the long-term efficacy at 3 months of treatment was comparably significant to that of alteplase with fewer adverse events.
文摘目的探讨注射用己酮可可碱联合阿加曲班治疗大动脉粥样硬化型急性缺血性脑卒中(large artery atherosclerotic acute ischemic stroke,LAA-AIS)伴阿司匹林抵抗的临床疗效及安全性。方法选择2021年1月—2023年12月收治的106例LAA-AIS伴阿司匹林抵抗患者作为研究对象,用随机数字表法分为观察组和对照组,每组53例。观察组给予注射用己酮可可碱联合阿加曲班治疗,对照组单用阿加曲班治疗。治疗结束后对2组的疗效进行评估。治疗前后对2组患者进行相关功能量表[美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、简易精神状态检查(Mini-Mental State Examination,MMSE)、改良Barthel指数(Modified Barthel Index,MBI)]评定;血栓弹力图[凝血反应时间(reaction time,R值)、血凝块形成时间(kinetics of clot formation,K值)、血凝块形成速率(angle of clot formation,Angle)、血凝块最大强度(maximum amplitude,MA)]检查;炎症相关指标[红细胞分布宽度变异系数(red cell distribution width-coefficient of variation,RDW-CV)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]检测;氧化应激指标[丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)]检测;比较2组不良反应的发生情况。结果观察组的总有效率显著高于对照组(90.57%vs.75.47%,P<0.05)。2组治疗后的NIHSS评分均显著下降(P<0.05),MMSE、MBI评分均显著升高(P<0.05),且均以观察组的变化更明显(P<0.05)。治疗后,2组的R值、K值均显著上升(P<0.05),Angle、MA均显著降低(P<0.05),且均以观察组的变化更明显(P<0.05)。治疗后,2组的RDW-CV、NLR、PLR、IL-6、TNF-α均显著降低(P<0.05),且观察组降低得更明显(P<0.001)。治疗后,2组的血清MDA含量均显著降低(P<0.05),血清SOD、GSH-Px活性均显著升高(P<0.05),且均以观察组的变化更明显(P<0.05)。2组不良反应发生率(11.32%vs.5.66%)比较差异无统计学意义(P>0.05)。结论注射用己酮可可碱联合阿加曲班治疗LAA-AIS伴阿司匹林抵抗能有效改善凝血功能,减轻炎症反应和氧化应激反应,促进患者神经功能和认知功能的恢复。
