目的 观察阿加曲班注射液治疗发病48 h内基底动脉尖综合征的临床疗效及安全性。方法 收集2017年1月—2022年5月在铜陵市人民医院治疗的56例基底动脉尖综合征患者，随机分为对照组和治疗组，每组各28例。对照组予以包括抗血小板聚集、改善脑循环、他汀、调控血糖、血压等常规治疗。治疗组在常规治疗的基础上静脉滴注阿加曲班注射液，前2 d 60 mg/d持续静脉泵入，持续48 h，后改为10 mg/次，2次/d，持续5 d。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）评分和Barthel指数（BI）评分。结果 治疗后，对照组和治疗组的总有效率分别为64.29%和89.28%，两组比较差异具有统计学意义（P＜0.05）。治疗后，两组NIHSS评分均低于治疗前（P＜0.05），BI评分治疗组显著高于治疗前（P＜0.05），且治疗组NIHSS评分和BI评分显著好于对照组（P＜0.05）。结论 阿加曲班治疗发病后48 h内基底动脉尖综合征患者的临床疗效和预后良好，且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of agatroban in treatment of patients with top of basilar artery syndrome within 48 hours after onset. Methods Patients (56 cases) with basilar apex syndrome in Tongling People' Hospital from January 2017 to May 2022 were randomly divided into control and treatment group, and each group had 28 cases. Patients in the control group was administered with routine treatment, including anti-platelet aggregation, improvement of cerebral circulation, statin, regulation of blood glucose, blood pressure and so on. Patients in the treatment group were iv administered with Argatroban Injection on the basis of routine treatment, 60 mg/d was continuously pumped intravenously for 48 h in the first 2 days, and then changed to 10 mg/time, twice daily, and they were treated for 5 d. After treatment, the clinical evaluation was evaluated, and the NIHSS scores and Barthel index in two groups before and after treatment were compared. Results After treatment, the total effective rates of the control group and the treatment group were 64.29% and 89.28%, respectively, with a statistically significant difference between the two groups (P < 0.05). After treatment, NIHSS scores in two groups were significantly lower than those before treatment (P < 0.05), while BI scores in treatment group were significantly higher than those before treatment (P < 0.05), and the scores of NIHSS and BI in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Argatroban has good clinical efficacy and prognosis in patients with basilar artery tip syndrome within 48 h after onset, and does not increase the incidence of adverse drug reactions.

R971