阿加曲班联合阿司匹林治疗急性后循环脑梗死的临床效果和安全性评估

发布时间：2018-06-26 01:16

本文选题：急性后循环脑梗死 + 阿加曲班　；参考：《中国医学前沿杂志(电子版)》2016年12期

【摘要】：目的评估阿加曲班联合阿司匹林治疗急性后循环脑梗死的临床效果和安全性。方法选取2013年1月至2015年12月于本院住院治疗的急性后循环脑梗死患者92例为研究对象。采用抽签法将入选患者随机分为单抗组(阿司匹林治疗)、双抗组(阿司匹林+氯吡格雷治疗)和观察组(阿加曲班+阿司匹林治疗),所有患者治疗7天后均改为单用阿司匹林治疗。分别于入院时(起病48小时内)、治疗1周及1个月后,采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)和巴氏指数(Barthel index,BI)评分评估三组患者的神经功能和生活能力,并于入院时和治疗1周后检测三组患者血小板(blood platelet,PLT)、活化部分凝血活酶时间(activated partialthromboplastin time,APTT)、凝血酶原国际标准化比值(international normalized ratio,INR)。结果入院时三组患者NIHSS评分和BI评分比较差异均无显著性(P0.05)。治疗1周后,观察组患者NIHSS评分低于单抗组和双抗组(P=0.014,P=0.039),BI评分高于单抗组(P=0.020),与双抗组比较无显著差异(P0.05)。治疗1个月后,双抗组和观察组患者NIHSS评分均低于单抗组(P=0.010,P0.001),观察组患者NIHSS评分低于双抗组(P=0.031);双抗组和观察组患者BI评分均显著高于单抗组(P=0.025,P=0.017),观察组患者BI评分高于双抗组(P=0.046)。治疗1周内,单抗组患者均未发生出血事件;双抗组和观察组各有1例患者发生出血事件,但两组患者出血事件发生率比较差异无显著性(χ~2=0.001,P=0.999)。入院时和治疗1周后,三组患者PLT、APTT及INR比较差异均无显著性(F=1.416,P=0.248)。结论阿加曲班联合阿司匹林治疗急性后循环脑梗死的效果优于单用阿司匹林和阿司匹林联合氯吡格雷,且安全性较好。
[Abstract]:Objective to evaluate the efficacy and safety of Agatripine combined with aspirin in the treatment of acute posterior circulation cerebral infarction. Methods 92 patients with acute posterior circulation cerebral infarction who were hospitalized in our hospital from January 2013 to December 2015 were selected. The selected patients were randomly divided into monoclonal antibody group (aspirin treatment), double antibody group (aspirin clopidogrel treatment) and observation group (Agatriban aspirin treatment) by drawing lots. Aspirin alone. At admission (within 48 hours), 1 week and 1 month after treatment, the National Institutes of Health Stroke scale NIHSS and Barthel Index BI were used to evaluate the neurological function and life ability of the three groups. The platelet (blood), activated partial thromboplastin time (activated partialthromboplastin time) and the international standardized ratio of prothrombin (international normalized ratioinr) were measured at admission and one week after treatment. Results there was no significant difference in NIHSS score and BI score between the three groups at admission (P0.05). After one week of treatment, the NIHSS scores in the observation group were lower than those in the monoclonal antibody group and the double antibody group (P0. 014) and the BI score was higher than that in the McAb group (P0. 020). There was no significant difference between the two groups (P0.05). After one month of treatment, the NIHSS scores in the double antibody group and the observation group were lower than those in the monoclonal antibody group (P0. 010 / P0.001), the NIHSS score in the observation group was lower than that in the double antibody group (P0. 031), the BI score in the double antibody group and the observation group was significantly higher than that in the monoclonal antibody group (P0. 025 P0. 017), and the BI score in the observation group was higher than that in the double antibody group (P0. 046). Within one week of treatment, no haemorrhage event occurred in all the patients in the McAb group, 1 case in the double antibody group and 1 case in the observation group, but there was no significant difference in the incidence of bleeding events between the two groups (蠂 ~ (2 +) (0.001) P ~ (0.999). At admission and 1 week after treatment, there was no significant difference in PLT APTT and INR between the three groups (F1. 416, P < 0. 248). Conclusion Agatripine combined with aspirin is more effective than aspirin combined with clopidogrel in the treatment of acute posterior circulation cerebral infarction.
【作者单位】：南京医科大学附属苏州医院神经内科;
【分类号】：R743.33

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