【摘要】 目的观察阿加曲班治疗急性腩梗死患者的临床效果及对血清和肽素(CPP)、N末端脑钠肽前体(NT-proBNP)的影响。方法 2013年2月—2015年2月收治的急性脑梗死患者70例,按随机数字表法分为观察组和对照组各35例,2组患者均给予常规吸氧、营养支持等对症治疗,观察组静脉滴注阿加曲班,对照组静脉滴沣奥扎格雷钠;观察2组患者临床疗效及治疗前后神经功能、日常生活能力、血液流变学变化情况,并测定血清CPP、NT-proBNP水平变化。结果观察组总有效率为91.4%(32/35),明显高于对照组的71.4%(25/35),差异有统计学意义(x~2=4.629,P<0.05);与治疗前比较,治疗后2组患者NIHSS评分和Barthel指数评分均有显著改善,差异有统计学意义(P<0.01),其中观察组治疗后1周、2周NIHSS评分显著低于对照组,Barthel评分显著高于对照组(P<0.05);2组治疗后血浆黏度、全血黏度、红细胞压积、红细胞聚集指数及血清CPP、NT-proBNP水平均较治疗前显著降低(P<0.01),其中观察组改善程度明显优于对照组(P<0.01)。结论阿加曲班治疗急性脑梗死患者疗效确切,明显改善血液流变学,显著降低血清CPP、NT-proBNP水平,有效改善神经功能,提高生活自理能力,值得临床推广应用。更多还原

【Abstract】 Objective To observe the clinical effect of argatroban on patients with acute cerebral infarction and impact on serum copeptin(CPP),N-terminal brain natriuretic peptide(NT-proBNP).Methods From February 2013 to February 2015,70 patients with acute cerebral infarction were enrolled.According to the random number table method,they were divided into observation group and control group,35 cases in each group.Patients in the two groups were given conventional oxygen therapy,nutritional support,symptomatic treatment,observation group was given intravenous drip of argatroban,control group with intravenous infusion of sodium ozagrel;to observe the changes of nerve function,activities of daily living and blood rheology in the 2 groups before and after treatment and determination of serum CPP,NT-proBNP levels.Results The total efficiency of observation group was 91.4%(32/35),which was significantly higher than the control group’s 71.4%(25/35),differences revealed statistical significant(x~2=4.629,P <0.05);compared with before treatment,2 groups of patients after treatment’s NIHSS score and Barthel index score improved significantly(P <0.01),1 week and 2 weeks after treatment,the observation group’s NIHSS were lower than the control group,Barthel score was higher than the control group(P < 0.05);after treatment,the 2 groups’ whole blood viscosity,plasma viscosity,hematocrit,erythrocyte aggregation index and serum CPP,NT-proBNP levels decreased significantly than before treatment(P <0.01),the observation group improved significantly than the control group(P < 0.01).Conclusion Argatroban therapy has definite curative effect in patients with acute cerebral infarction and improve blood rheology,significantly reduced the serum CPP,NT-proBNP levels,effectively improve the nerve function,improve self-care ability,it is worthy of clinical application.更多还原