目的 观察阿加曲班在治疗轻型缺血性脑卒中的疗效和安全性。方法 回顾性选择2022年1月—2022年12月于南方医科大学附属何贤纪念医院神经内科因急性缺血性脑卒中住院的分类为轻型卒中［美国国立卫生研究院卒中量表（NIHSS）小于9分］患者61例为研究对象，根据治疗期间有无规范使用阿加曲班药物治疗分为试验组和对照组，对照组按照常规急性缺血性脑卒中诊疗方案治疗，即在时间窗内对于符合静脉溶栓和机械取栓的患者进行急性期治疗，在非时间窗内就诊的患者进行抗血小板、改善循环、监控血压、血糖等支持治疗；试验组在常规治疗基础上给予阿加曲班注射液治疗，即发病48 h内的患者在入院后24 h内以5 mL·h-1持续静脉泵入，随后以每天20 mg，分2次以0.9%氯化钠注射液250 mL稀释后静脉滴注，疗程7 d。分别记录患者出院时NIHSS评分及入院与出院NIHSS评分差值，同时记录入院和出院时的改良Rankin（mRS）评分，所有患者均进行系统性检查并进行TOAST分型。记录住院期间的血小板减少、便血或颅内出血等不良事件发生情况。结果 试验组患者住院期间NIHSS评分较对照组改善明显（P<0.05）；但出院时mRS评分良好率（mRS评分为0～2分患者占比）两组比较差异不明显（P>0.05）；两组患者均无不良事件发生。结论 阿加曲班可以改善轻型缺血性卒中患者的临床症状并安全性较高。
Objective To analyze the efficacy and safety of argatroban in patients with mild ischemic stroke to provide more effective treatments and to improve prognosis. Methods Retrospective analysis of 61 patients hospitalized for acute cerebral infarction and classified in mild stroke (NIHSS score is in less than 9) in the Department of Neurology of HeXian Memorial Affiliated Hospital of Southern Medical University, from January 2022 to December 2022. All patients had imaging diagnostic supports and were evaluated by attending specialists. According to the standard use of argatroban during the treatment period, the patients were divided into argatroban group (experimental group) and non-argatroban group (control group). Patients in the control group were treated according to the conventional acute ischemic stroke diagnosis and treatment plan, that is, patients who meet the requirements of intravenous thrombolysis and mechanical thrombectomy were treated in the acute phase within the time window, while patients who seek treatment outside the time window were treated with antiplatelet therapy, improved circulation, monitoring blood pressure, blood glucose, and other supportive treatments. On the basis of routine treatment, patients in the experimental group were treated with Agatroban Injection. Patients within 48 hours of onset were continuously pumped 5 mL·h-1 intravenously within 24 hours of admission, followed by 20 mg daily, diluted with 250 mL of 0.9% Sodium Chloride Injection twice, and intravenous drip for seven days.The age, gender, history of hypertension, diabetes, NIHSS score and difference of NIHSS score from admission to discharge was recorded respectively, and the modified Rankin scale (mRS) at admission and discharge was recorded, and all patients were systematically examined and TOAST typed. Any occurrence of thrombocytopenia, hematochezia or intracranial hemorrhage during hospitalization was considered an adverse event. Results The improvement in NIHSS score in experimental group was better than control group (P= 0.022); However, the good discharge rate (proportion of patients with mRS 0—2) was not significantly different between two groups (P= 0.449), and no adverse events occurred in all enrolled cases. Conclusion Argatroban can improve clinical symptoms and has high safety in patients with mild ischemic stroke.