目的 观察阿加曲班治疗急性进展性脑梗死的临床疗效及安全性.方法 选取2013年5月—2014年5月在内蒙古自治区人民医院住院的急性进展性脑梗死患者50例,随机分为治疗组(25例)和对照组(25例).治疗组患者第1、2天每天用阿加曲班注射液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.对照组静脉滴注注射用奥扎格雷钠,80 mg/次,以500 mL生理盐水稀释,2次/d,连续7 d.两组其他治疗持续14 d.治疗后,观察两组患者的临床疗效,同时比较治疗前后两组患者的NIHSS评分和Barthel指数变化.结果 治疗组和对照组总有效率分别为88.0%、72.0%,两组总有效率比较差异有统计学意义(P<0.05).两组治疗14 d与治疗前比较NIHSS评分均明显降低,同组治疗前后差异有统计学意义(P<0.05).两组治疗后Barthel指数较治疗前均明显提高,治疗前后差异有统计学意义(P<0.05).治疗后,治疗组这两项指标改善程度优于对照组,差异有统计学意义(P<0.05).结论 阿加曲班注射液治疗急性进展性脑梗死具有较好的临床疗效,可降低NIHSS评分,提高Barthel指数,值得临床推广应用.

Objective To explore the effect and safety of Argatroban Injection in treatment of acute progressive cerebral infarction. Methods Patients with acute progressive cerebral infarction who came to Inner Mongolia People's Hospital from May 2013 to May 2014 (50 cases) were randomly divided into treatment (25 cases) and control (25 cases) groups. The patients in the treatment group were treated with Argatroban Injection (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 Injection (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 iv administered with Ozagreiner for injection 80 mg/time which was diluted with 500 mL physiological saline, twice daily, for 7 d. Ather treatment in two groups lasted 14 d. After treatment, the treatment efficacy was evaluated, while the changes of NIHSS score and Barthel indexes in two groups were compared. Results The efficacies in the treatment and control groups were 88.0% and 72.0%, respectively, with differences between the two groups (P < 0.05). Within 14 d after the treatment, the NIHSS scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant in the same group (P < 0.05). After treatment, Barthel index of the two groups were significantly improved than those before treatment, and the difference was statistically significant in the same group (P < 0.05). After treatment, the two indicators in the treatment group improved better than those in the control group, with the significant difference between two groups (P < 0.05). Conclusion Argatroban Injection has good clinical effect in treatment of acute progressive cerebral infarction, and can reduce the NIHSS score and improve the Barthel index, which is worthy of clinical application.