阿加曲班治疗急性缺血性卒中的临床应用

摘要

Argatroban is a direct thrombin inhibitor with the advantages of rapid onset, short duration of effect, less tendency of bleeding and no immunogenicity, which can effectively prevent thrombosis and secondary microthrombosis. Several studies home and abroad had proved that argatroban could effectively improve the neurologic symptoms and daily activity ability of patients with acute ischemic stroke, and it also had therapeutic effect in patients with acute atherosclerotic stroke or cardioembolic stroke. Compared with aspirin, ozagrel and and other antiplatelet drugs or heparin, argatroban has higher safety. Due to the different mechanism of action, the combination therapy with aspirin, clopidogrel and other antiplatelet drug or recombinant tissue plasminogen activator (rt-PA) may show the possibility of synergistic effect. This paper focuses on the clinical application of argatroban in the treatment of acute ischemic stroke.%阿加曲班是一种直接凝血酶抑制剂,具有起效较快、作用时间短、出血倾向小、无免疫源性等优点,能够有效阻止血栓进展,防止继发微血栓形成.国内外多项研究证实,阿加曲班能有效改善急性缺血性卒中患者的神经系统症状和日常活动能力,且对急性动脉粥样硬化性卒中和心源性卒中均有治疗作用,此外,阿加曲班与阿司匹林、奥扎格雷等抗血小板药物以及肝素相比疗效更显著,具有较高的安全性,同时由于作用机制不同,阿加曲班与阿司匹林、氯吡格雷等抗血小板药物、重组组织型纤溶酶原激活物(recombinant tissue plasminogen activator,rt-PA)联合治疗可能发挥协同作用.本文就阿加曲班在急性缺血性卒中的临床应用做一系统性综述.