目的 观察阿加曲班治疗急性脑梗死患者的临床疗效及安全性。方法 采用随机、阳性对照研究，将42例急性脑梗死患者随机分为对照组（20例）和治疗组（22例）。治疗组患者第1、2天每天用阿加曲班60 mg以500 mL生理盐水稀释，24 h持续静脉泵注；其后的5 d用阿加曲班20 mg以100 mL生理盐水稀释，分早晚2次持续静脉泵注，每次3 h，持续治疗7 d。对照组患者第1、3天，每天用巴曲酶10 BU，以生理盐水100 mL稀释，第5天巴曲酶5 BU以生理盐水100 mL稀释，静脉滴注，1 h内滴完；巴曲酶共间隔治疗5 d。两组患者在上述治疗的基础上均给予疏血通6 mL，1 次/d，静脉滴注14 d，口服阿司匹林100 mg、阿托伐他汀20 mg，同时控制血压、血糖、对症等基础治疗，延续至出院后60 d。根据治疗前、后14 d NIHSS评分评定即刻疗效；根据治疗前及治疗后60 d mRS得分来评价患者临床预后和生活自理能力，同时观察两组患者的不良反应。结果 两组治疗后14 d NIHSS评分均明显低于治疗前（P＜0.05），两组比较差异无统计学意义；mRS评分治疗组低于对照组，差异有统计学意义（P＜0.05）。两组均未出现出血、皮疹等不良反应。结论 阿加曲班治疗急性脑梗死，疗效确切、安全，无明显不良反应，患者后期生活自理能力优于巴曲酶注射液。

Objective To evaluate the efficacy and safety of argatroban in the treatment of acute cerebral infarction. Methods The patients (42 cases) diagnosed as acute cerebral infarction were randomly divided into treatment (22 cases) and control (20 cases) groups, and the studies were positive controlled. The patients in the treatment group were treated with argatroban (60 mg diluted with 500 mL physiological saline) through 24 h continuous iv pump infusion on the first 2 d. The next 5 d they were treated with argatroban (20 mg diluted with 100 mL physiological saline), through continuous 3 h iv infusion twice daily in the morning and evening. They were treated for 7 d. The patients in the control group were treated with batroxobin (10 BU diluted with 100 mL physiological saline) on the days 1 and 3. On the day 5, they were injected with batroxobin (5 BU diluted with 100 mL physiological lsaline) through 1h iv drip. Every other day the therapy was continued for the patients until the day 5. The patients in the two groups on the basis of the above treatments were iv infused with Shuxuetong 6 mL, once daily for continuous 14 d, and po administered with Aspirin 100 mg and Atorvastatin 20 mg, while the blood pressure and blood sugar were controlled. The other basic symptomatic treatment was continued until 60 d after discharge. The effects were evaluated by index of NIHSS before and 14 d after the treatment. The clinical prognosis and self-care ability were evaluated by index of MRS before and 60 d after the treatment, while the side effects of the two groups were observed. Results Within 14 d after the treatment, the NIHSS scores of the two groups were significantly lower than those before the treatment (P < 0.05), and the difference between the two groups was not statistically significant. The mRS score in the treatment group was lower than that in the control group, with the significant difference (P < 0.05). The patients in the two groups had no bleeding, rash, or other side effects. Conclusion Argatroban used for the treatment of acute cerebral infarction is effective and safe with no significant side effects. The patients with argatroban treatment have better self-care ability in the later life than those with Batroxobin Injection.