目的 比较阿加曲班注射液和注射用尤瑞克林治疗早期急性进展性脑梗死的有效性、安全性。方法 选取2018年1月-2019年5月在通辽市医院住院并在发病72 h内进展的92例急性脑梗死患者，随机分成阿加曲班组和尤瑞克林组，每组各46例。阿加曲班组静脉泵入阿加曲班注射液，60 mg/d治疗2 d，然后10 mg/d治疗5 d，早晚各1次，每次持续3 h。尤瑞克林组静脉滴注注射用尤瑞克林0.15 PNA单位/d，前15 min内控制滴速。两组连续治疗14 d。观察两组患者临床疗效，同时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指数评定量表（BI）评分。结果 治疗后，阿加曲班组临床有效率为82.6%，显著高于尤瑞克林组的69.6%，两组比较差异有统计学意义（P<0.05）。阿加曲班组在治疗7、14 d后NIHSS评分较治疗前明显降低（P<0.05），而尤瑞克林组在治疗14 d后才显示出明显改善（P<0.05）；治疗后阿加曲班组NIHSS评分显著低于尤瑞克林组同期，两组比较差异具有统计学意义（P<0.05）。阿加曲班组在治疗7、14 d后BI分值明显升高（P<0.05），而尤瑞克林组则在治疗14 d后与治疗前比较才显示出显著差异（P<0.05）；治疗后阿加曲班组BI分值显著高于尤瑞克林组同期，两组比较差异具有统计学意义（P<0.05）。结论 阿加曲班注射液治疗进展性脑梗死早期进展患者有较好的临床疗效，安全性好。

Objective To compare the efficacy and safety of argatroban and urinary kallidinogenase in treatment of progressive cerebral infarction. Methods Patients (92 cases) with progressive cerebral infarction progressed within 72 h and hospitalized in Tongliao Hospital from January 2018 to May 2019 were randomly divided into argatroban and urinary kallidinogenase groups, and each group had 46 cases. Patients in the argatroban group were iv pumped administered with Argatroban Injection, 60 mg/d for 2 d, then 10 mg/d for 5 d, once in the morning and evening and lasted for 3 h each time. Patients in the urinary kallidinogenase group were iv administered with Urinary Kallidinogenase for injection, 0.15 PNA U/d, controlled dropping speed in the first 15 min. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, NIHSS and BI scores in two groups were compared. Results After treatment, the clinical efficacy in the argatroban group was 82.6%, which was significantly higher than 69.6% in the urinary kallidinogenase group (P < 0.05). After treatment for 7 and 14 d, the NIHSS scores in the argatroban group were significantly decreased (P < 0.05), but which in the urinary kallidinogenase group were significantly improved after treatment for 14 d (P < 0.05). After treatment, NIHSS score in agajuban group was significantly lower than that in urinary kallidinogenase group, and there were differences between two groups (P < 0.05). After treatment for 7 and 14 d, the BI scores in argatroban group were significantly increased (P < 0.05), but the difference in the urinary kallidinogenase group compared with that before treatment was statistically significant after treatment for 14 d (P < 0.05). After treatment, BI scores in agajuban group was significantly higher than that in urinary kallidinogenase group, and there were differences between two groups (P < 0.05).Conclusion Agatraban has good clinical efficacy and safety in the treatment of early progressive cerebral infarction.

R971

内蒙古自治区科技计划项目（201702130）