目的 探讨阿加曲班对下肢动脉硬化闭塞合并急性血栓形成的老年患者的治疗效果以及治疗过程中对凝血功能的影响。方法 回顾性选取2018年5月—2021年10月民航总医院收治的下肢动脉硬化闭塞合并急性血栓形成的年龄≥65岁的老年患者67例，随机分为对照组（n＝33）和试验组（n＝34），对照组采用那屈肝素钙注射液（每次4 100 U，每12小时给药1次）抗凝，试验组采用阿加曲班注射液（20 mg加入到160 mL 0.9%氯化钠注射液中，泵速20 mL·h⁻¹，每天2次，2次之间间隔2 h）抗凝，两组患者均连续治疗7 d。比较两组患者治疗效果、凝血功能指标变化及治疗过程中并发症及不良反应发生的情况。结果 治疗后，对照组总有效率为78.79%；试验组总有效率为82.35%，两组总有效率比较，差异无统计学意义（P＞0.05）。与治疗前相比，治疗后两组患者D-二聚体、纤维蛋白原（FBG）、血小板计数（PLT）水平均显著降低（P＜0.05），活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）明显延长（P＜0.05），血浆黏度及红细胞比积均显著降低（P＜0.05）；治疗第3天试验组D-二聚体水平显著低于对照组（P＜0.05）；治疗后试验组FBG、血浆黏度、红细胞比积水平降低程度，APTT、PT延长程度与对照组比较差异无统计学意义（P＞0.05）。试验组不良反应发生率显著低于对照组（P＜0.05）。结论 阿加曲班治疗下肢动脉硬化闭塞合并急性血栓形成的老年患者临床疗效显著，对患者D-二聚体、FBG、APTT、PT指标改善有积极作用，并可调节血液流变学状态，安全性高。

Objective To observe the therapeutic effect of argatroban in elderly patients with lower extremity arteriosclerosis occlusion complicated with thrombosis and its effect on coagulation function. Methods From May 2018 to October 2021, 67 elderly patients with lower extremity arteriosclerosis occlusion complicated with acute thrombosis aged ≥ 65 years were retrospectively selected and randomly divided into control group (n = 33) and experimental group (n = 34). Patients in the control group were anticoagulated with Nadroparin Calcium Injection (4 100 U each time, once every 12 h), Patients in the experimental group were treated with Argatroban Injection (20 mg was added to 160 mL 0.9% Sodium Chloride Injection, the pump speed was 20 mL·h⁻¹, twice a day, with an interval of two hours). The patients in both groups were treated for seven days. The therapeutic effect, changes of coagulation function indexes, complications and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the control group was 78.79%, the total effective rate of the experimental group was 82.35%. There was no significant difference between the two groups (P > 0.05). Compared with before treatment, the levels of D-dimer, fibrinogen (FBG) and platelet count (PLT) in two groups decreased significantly (P < 0.05), the levels of activated partial thromboplastin time (APTT) and prothrombin time (PT) in two groups increased significantly (P < 0.05), and the plasma viscosity and hematocrit in two groups decreased significantly (P < 0.05). On the third day of treatment, the level of D-dimer in the experimental group was significantly lower than that in the control group (P < 0.05). After treatment, there was no significant difference between the experimental group and the control group in the decrease of FBG, plasma viscosity and hematocrit, and the increase of APTT and PT (P > 0.05). The incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion Argatroban is effective in the treatment of elderly patients with lower extremity arteriosclerosis occlusion complicated with acute thrombosis. It has a positive effect on the improvement of D-dimer, FBG, APTT and PT, and can regulate the state of hemorheology with high safety. K

R971