阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死的临床效果分析

杨玉华

[摘要]目的 探讨阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死的临床效果。方法 将我院2015年4月～2016年8月收治的74例大动脉粥样硬化性脑梗死患者作为研究对象，以随机为基本原则，将其分为对照组与观察组，各37例。对照组使用氯吡格雷治疗，在此基础上，观察组予以阿加曲班联合治疗。观察两组治疗前后神经功能缺损、日常生活能力、炎性因子水平以及不良反应发生情况。结果 观察组治疗后神经功能缺损评分为（4.71±0.63）分，日常生活能力评分为（81.82±2.33）分，白细胞介素-8水平为（0.36±0.28）ng/ml，肿瘤坏死因子-α水平为（0.40±0.19）ng/ml，均优于对照组（P<0.05）；两组的不良反应发生率差异无统计学意义（P>0.05）。结论 阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死，可明显改善神经缺损及生活能力，且安全性较高。

[关键词]氯吡格雷；阿加曲班；大动脉粥样硬化性脑梗死

[中图分类号] R743.9 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0059-03

Clinical effect analysis of Argatroban combined with Clopidogrel in the treatment of large-artery atherosclerosis-induced cerebral infarction

YANG Yu-hua

Department of Neurology，the First Affiliated Hospital of Shantou University Medical College in Guangdong Province，Shantou 515041，China

[Abstract]Objective To evaluate the clinical effect of Argatroban combined with Clopidogrel in the treatment of large-artery atherosclerosis-induced cerebral infarction.Methods A total of 74 patients with large-artery atherosclerosis-induced cerebral infarction treated by our hospital from April 2015 to August 2016 were selected as research objects.Based on randomization，they were divided into control group （n=37） and observation group （n=37）.In the control group，Clopidogrel was used，on the basis，Argatroban was added in the observation group.The neurologic impairment，activity of daily living，inflammatory factor levels，and occurrence of adverse reactions before and after treatment in two groups were observed.Results In the observation group，the scores of neurologic impairment and activity of daily living were （4.71±0.63） points and （81.82±2.33） points after treatment.The levels of interleukin-8 and tumor necrosis factor-α were （0.36±0.28） ng/ml and （0.40±0.19） ng/ml，which were all superior to those in the control group with statistical differences （P<0.05）.Difference in incidence rate of adverse reactions was not great （P>0.05）.Conclusion Argatroban combined with Clopidogrel in the treatment of large-artery atherosclerosis-induced cerebral infarction can remarkably improve the neurologic impairment and activity of daily living in high safety.

[Key words]Clopidogrel；Argatroban；Large-artery atherosclerosis-induced cerebral infarction

腦梗死即为缺血性卒中，疾病诱发原因较多，主要是因机体脑组织发生局部供血障碍所致，患者脑组织发生缺氧、缺血性坏死会直接造成神经功能缺损表现，可分为腔隙性、脑栓塞以及脑血栓形成脑梗死。此疾病起病较急，致死、致残概率均较高，对人类健康存在着严重威胁，急性脑梗死中大动脉粥样硬化性最为多见[1]，主要是由动脉栓塞、低灌注等因素诱发。临床多使用尿激酶溶栓治疗，但因时间限制[2]，部分患者并不能及时实施溶栓治疗，故寻找有效避免神经缺损的方法极为重要。阿加曲班属于凝血酶抑制剂，具有高度选择性，临床发现此药物对于血凝块相连或者游离的凝血酶均有效。本文探讨阿加曲班联合氯吡格雷治疗大动脉粥样硬化性脑梗死的临床效果，现报道如下。