[1]栗延伟,张军艳,兰春伟.丹参多酚酸联合阿加曲班治疗进展性脑梗死疗效观察[J].新乡医学院学报,2019,36(4):357-360.[doi:10.7683/xxyxyxb.2019.04.014]
　LI Yan-wei,ZHANG Jun-yan,LAN Chun-wei.Clinical efficacy of salvianolate combined with argatroban in the treatment of progressive stroke[J].Journal of Xinxiang Medical University,2019,36(4):357-360.[doi:10.7683/xxyxyxb.2019.04.014]
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丹参多酚酸联合阿加曲班治疗进展性脑梗死疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年4
页码:
357-360
栏目:
临床研究
出版日期:
2019-04-05

文章信息/Info

Title:
Clinical efficacy of salvianolate combined with argatroban in the treatment of progressive stroke
作者:
栗延伟1; 张军艳1; 兰春伟2
（1.新乡医学院第三附属医院神经内二科，河南　新乡　453003；2.中国科学院大学深圳医院神经内科，广东　深圳　518107）
Author(s):
LI Yan-wei1; ZHANG Jun-yan1; LAN Chun-wei2
（1.Department of Neurology，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province，China；2.Department of Neurology，Shenzhen Hospital，University of Chinese Academy of Sciences，Shenzhen 518107，Guangdong Province，China）
关键词:
丹参多酚酸; 阿加曲班; 进展性脑卒中; 临床疗效; 安全性
Keywords:
salvianolate; argatroban; progressive stroke; clinical efficacy; security
分类号:
R743.3
DOI:
10.7683/xxyxyxb.2019.04.014
文献标志码:
A
摘要:
目的　探讨丹参多酚酸联合阿加曲班治疗进展性脑梗死的临床疗效及安全性。方法　将新乡医学院第三附属医院和中国科学院大学深圳医院2015年5月至2017年5月收治的126例进展性脑梗死患者分为对照组（n=62）和观察组（n=64）。2组患者均给予常规治疗，在常规治疗基础上，对照组患者48 h内给予60 mg阿加曲班加入500 mL生理盐水中持续静脉泵入，48 h后改为10 mg阿加曲班加入250 mL生理盐水中静脉滴注，每日2次，连续 5 d。观察组患者在对照组治疗基础上给予100 mg丹参多酚酸加入250 mL生理盐水中静脉滴注，每日1次，连用 14 d。采用美国国立卫生研究院卒中量表（NIHSS）和Barthel指数量表评估2组患者治疗前后神经功能缺损及神经功能康复情况，比较2组患者治疗前后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、红细胞比容、血小板黏附率，并观察2组患者不良反应发生情况。结果　2组患者治疗前NIHSS评分及Barthel指数比较差异无统计学意义（P>0.05）。2组患者治疗后NIHSS评分显著低于治疗前（P<0.01），Barthel指数显著均高于治疗前（P<0.05）；治疗后，观察组患者NIHSS评分显著低于对照组（P<0.01），Barthel指数显著高于对照组（P<0.01）。2组患者治疗前全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平、红细胞比容及血小板黏附率比较差异无统计学意义（P>0.05）。2组患者治疗后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平、红细胞比容及血小板黏附率显著低于治疗前（P<0.05）；观察组患者治疗后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平、红细胞比容及血小板黏附率显著低于对照组（P<0.05）。对照组和观察组患者治疗总有效率分别为83.9%（52/62）和96.8%（62/64），观察组患者治疗总有效率高于对照组（χ2=5.893，P<0.05）。对照组和观察组患者不良反应发生率分别为16.1%（10/62）和18.8%（12/64），2组患者不良反应发生率比较差异无统计学意义（χ2=0.221，P>0.05）。结论　丹参多酚酸联合阿加曲班治疗进展性脑梗死能够显著改善患者的神经功能缺损情况，提高神经功能康复效果，降低患者的血液黏稠度，且用药安全性较好。
Abstract:
Objective　To explore the clinical efficacy of salvianolate combined with argatroban in the treatment of progressive stroke.Methods　One hundred and twenty-six patients with progressive stroke admitted to the Third Affiliated Hospital of Xinxiang Medical University and Shenzhen Hospital of the University of Chinese Academy of Sciences from May 2015 to May 2017 were divided into control group（n=62） and observation group（n=64）.The patients in the control group were treated with conventional treatment and given 60 mg argatroban which was added to 500 mL saline solution for continuous intravenous pumping within 48 hours，and 10 mg argatroban which was added to 250 mL saline solution for intravenous infusion after 48 hours，twice a day for five days.On the basis of treatment of the control group，the patients in the observation group were given 100 mg salvianolate which was added to 250 mL saline solution for intravenous infusion，once a day for 14 days.The neurologic deficits and neural function recovery was assessed by the national institutes of health stroke scale （NIHSS） scores and Barthel index scale before and after treatment.The whole blood high shear viscosity，whole blood low shear viscosity，plasma viscosity，fibrinogen，erythrocyte pressure，platelet adhesion rate were compared between the two groups before and after treatment，and the adverse reactions were observed in the two groups.Results　There was no significant difference in the NIHSS score and Barthel index between the two groups before treatment （P>0.05）.After treatment，the NIHSS scores of the two groups were significantly lower than those before treatment （P<0.01），and the Barthel index was significantly higher than those before treatment （P<0.05）.After treatment，the NIHSS score of the observation group was significantly lower than that of the control group （P<0.01），and the Barthel index was significantly higher than that of the control group （P<0.01）.There was no statistically significant difference in the whole blood high shear viscosity，whole blood low shear viscosity，plasma viscosity，fibrinogen，erythrocyte pressure，platelet adhesion rate between the two groups before treatment （P>0.05）.The whole blood high shear viscosity，whole blood low shear viscosity，plasma viscosity，fibrinogen，erythrocyte pressure，platelet adhesion rate in the two groups after treatment were lower than those before treatment（P<0.05）.The whole blood high shear viscosity，whole blood low shear viscosity，plasma viscosity，fibrinogen，erythrocyte pressure，platelet adhesion rate in the observation group after treatment was lower than those in the control group （P<0.05）.The total effective rate in the control group and the observation group was 83.9% （52/62） and 96.8% （62/64），respectively.The total effective rate in the observation group was higher than that in the control group （χ2=5.893，P<0.05）.The incidence of adverse reactions in the control group and the observation group was 16.1% （10/62） and 18.8% （12/64），respectively.There was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.221，P>0.05）.Conclusion　Salvianolate combined with argatroban in the treatment of progressive cerebral infarction can significantly improve the neurological defects and the neurological rehabilitation effect，reduce the blood viscosity of patients，and the safety of medication is good.

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更新日期/Last Update: 2019-04-05