阿加曲班治疗不同脑组织缺血范围进展性脑卒中的临床观察

发布时间：2018-05-27 12:08

本文选题：前循环缺血性脑卒中 + 后循环缺血性脑卒中　；参考：《中国药房》2017年17期

【摘要】：目的:研究不同脑组织缺血范围进展性脑卒中患者采用阿加曲班治疗的临床效果。方法:选择2015年2月-2016年5月我院神经内科收治的进展性脑卒中患者116例,根据脑组织缺血范围分为前循环(缺血)组60例、后循环(缺血)组50例、腔隙性(脑梗死)组6例。3组患者均采用基础治疗联合阿加曲班治疗,于病情加重当天及第2天采用阿加曲班60 mg/d静脉持续泵入,病情缓解后的第5天减量为10 mg经静脉持续泵入治疗,3 h/次,bid,7 d为1个疗程。比较3组患者美国国立卫生院卒中量表(NIHSS)评分、改良RANKIN量表(m RS)评分、活化部分凝血活酶时间(APTT)及不良反应发生情况。结果:治疗后14 d,3组患者NIHSS、m RS评分均较治疗前显著降低,差异均有统计学意义(P0.05);且前循环组与后循环组比较,差异有统计学意义(P0.05)。治疗2 h时,3组患者APTT均较治疗前显著延长,且腔隙性组最为明显,组间比较差异有统计学意义(P0.05);治疗48 h时,3组患者APTT均恢复至正常水平,组间比较差异无统计学意义(P0.05)。3组患者均未见明显不良反应发生。结论:阿加曲班治疗不同脑组织缺血范围的进展性脑卒中均能取得显著疗效,且安全性高;尤其是针对前循环缺血性脑卒中患者显效快、抗凝效果显著。
[Abstract]:Objective: to study the clinical effect of Agatriban in patients with progressive stroke with different ischemic range. Methods: 116 patients with progressive stroke treated in neurology department of our hospital from February 2015 to May 2016 were divided into anterior circulation group (60 cases) and posterior circulation group (50 cases) according to the ischemic range of brain tissue. In the lacunar (cerebral infarction) group, 6 patients in group 3 were treated with basic therapy combined with agatropine, and the patients were continuously injected with Agatripine for 60 mg/d on the day of aggravation and the second day. On the 5th day after remission, the dosage of 10 mg was continuously injected intravenously for 3 h / time for 7 days as a course of treatment. NIHSS score, modified RANKIN scale, activated partial thromboplastin time (APTT) and adverse events were compared among the three groups. Results: after 14 days of treatment, the NIHSS mRS scores in the three groups were significantly lower than those before treatment, and the difference was statistically significant (P 0.05), and the difference between the anterior circulation group and the posterior circulation group was statistically significant (P 0.05). At 2 h after treatment, the APTT of the 3 groups was significantly longer than that of before treatment, and the lacunar group was the most obvious, and the difference between the three groups was statistically significant (P 0.05), and the APTT of the 3 groups returned to the normal level at 48 h after treatment. There was no significant difference between the two groups. Conclusion: the treatment of progressive stroke with different ischemic range of cerebral tissue by Agatripine has significant curative effect and high safety, especially for the patients with anterior circulation ischemic stroke, and the anticoagulant effect is remarkable.
【作者单位】：天津港口医院药剂科;天津港口医院麻醉科;天津港口医院神经内科;
【分类号】：R743.3

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