阿加曲班联合硫酸氢氯吡格雷治疗急性脑梗死疗效及安全性评估

摘要

目的：观察阿加曲班和硫酸氢氯吡格雷联合应用及单用阿加曲班抗凝在治疗急性脑梗死治疗效果比较及风险评估。方法选取我院急性脑梗死发病48 h内入院患者110例，随机分成两组，一组为常规脑保护，活血化瘀治疗基础上单用阿加曲班抗凝组；另一组为常规治疗基础上阿加曲班抗凝联合硫酸氢氯吡格雷抗血小板治疗。治疗前、治疗48 h后、1周后及2周后以美国国立卫生院卒中量表（NIHSS）评分评估两组患者神经功能变化并对比二者患者凝血功能相关指标变化情况，同时观察记录患者的不良反应。结果（1）阿加曲班联用硫酸氢氯吡格雷较单用阿加曲班神经功能评分改善明显，且无增加明显不良反应；（2）阿加曲班及阿加曲班联用硫酸氢氯吡格雷治疗1周时神经功能恢复尤为显著，此后恢复较慢。结论阿加曲班联合硫酸氢氯吡格雷治疗急性脑梗死安全有效。%Objective To compare the different effects of combined application of argatroban and clopidogrel hydrogen sulfate, and separate application of argatroban anticoagulant in the treatment of acute cerebral infarction and evaluate the risks.Methods 110 cases of acute cerebral infarction patients admitted to our hospital within 48 hours of occurrence were selected, and randomly divided into two groups. One group was treated by routine cerebral protection, and prescribed with argatroban anticoagulant on the basis of blood circulation therapy. Other group was treated with the combined application of argatroban and clopidogrel hydrogen sulfate anti-platelet on the basis of conventional therapy. The neurological function changes and coagulation function changes of the patients in two groups were evaluated and compared with NIHSS scale after 48 h, 1 week and 2 weeks of the treatment;meanwhile, the side effects of patients were recorded.Results (1) Neurological function of patients treated with the combined application of argatroban and clopidogrel hydrogen sulfate is much better improved than patients treated with separate application of argatroban, and no signiifcant adverse effect was observed. (2) The recovery of neurological function achieved the most significant improvement at 1week after the treatment, and then slowed down. This conclusion is suitable for the combined application of argatroban and clopidogrel hydrogen sulfate, and separate application of argatroban in patients.Conclusion Combined therapy with clopidagrel hydrogen sulfate and argatroban of acute cerebral infarction is safe and effective.