| 史俊,张虚琴,缪莲莲,黄红伟.阿加曲班对轻型大动脉粥样硬化性缺血性卒中患者神经功能及血管反应性的影响[J].济宁医学院学报,2025,48(4):347-352 |
| 阿加曲班对轻型大动脉粥样硬化性缺血性卒中患者神经功能及血管反应性的影响 |
| Effects of argatroban on neurological function and vascular reactivity in patients with mild atherosclerotic ischemic stroke |
| 投稿时间：2024-09-28 |
| DOI：10.3969/j.issn.1000-9760.2025.04.012 |
| 中文关键词: 阿加曲班;轻型卒中;大动脉粥样硬化性卒中;经颅多普勒超声 |
| 英文关键词: Argatroban;Mild stroke;Large artery atherosclerotic stroke;Transcranial doppler ultrasound |
| 基金项目:常州市科技计划项目(CJ20209001) |
| 作者 | 单位 | | 史俊 | 溧阳市人民医院神经内科 | | 张虚琴 | 溧阳市人民医院功能科, 溧阳 213300 | | 缪莲莲 | 溧阳市人民医院神经内科 | | 黄红伟 | 溧阳市人民医院神经内科 |
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| 中文摘要: |
| 目的 探讨阿加曲班对轻型大动脉粥样硬化性缺血性卒中(LAAS)患者神经功能和血管反应性的影响。方法 连续纳入2021年6月至2023年6月入院的急性轻型LAAS患者160例,随机分为阿加曲班组(n=80)和对照组(n=80)。分别在治疗前、治疗7d后对患者进行美国国立卫生院卒中量表(NIHSS)、改良Rankin量表(mRS)、简明精神状态量表(MMSE)的评估和经颅多普勒超声(TCD)屏气试验,比较两组间的结果。结果 2组患者基线资料差异无统计学意义(P＞0.05)。治疗7d后,对照组进展性卒中发生率33.8%,高于阿加曲班组的15%,差异有统计学意义(χ2=0.629,P=0.006)。治疗7d后,阿加曲班组NIHSS评分为[2.0(1.0,3.0)分],低于对照组[3.0(1.0,6.0)分](P=0.017),组内比较阿加曲班组治疗后低于治疗前的[3.0(2.0,5.0) 分](P=0.002)。治疗7d后,阿加曲班组中mRS评级为0~2的患者占比为83.8%,高于对照组的70.0%(P=0.040)。治疗7d后,阿加曲班组MMSE评分[(24.96±3.37)分]高于对照组[(22.67±4.01)分](P＜0.001)和治疗前[(22.12±3.35)分](P＜0.001)。阿加曲班组治疗7d后的屏气前平均血流速度[(50.16±10.39)cm/s]高于治疗前[(44.16±10.63)cm/s](P＜0.05)。阿加曲班组治疗7d后的屏气后平均血流速度[(65.41±13.20)cm/s]高于治疗前[(55.41±12.56)cm/s](P＜0.05),且高于治疗后对照组[(58.54±11.25)cm/s](P=0.028)。阿加曲班组治疗7d后的屏气指数(BHI)(0.50±0.14)高于治疗前(0.37±0.10)(P＜0.001),高于治疗后对照组(0.40±0.09)(P=0.001)。结论 阿加曲班可以改善急性轻型LAAS患者的脑血流调节能力,减少进展性卒中的发生,改善患者的肢体功能和认知功能。 |
| 英文摘要: |
| Objective To explore the effect of agatroban on neurological function and vascular reactivity in patients with mild atherosclerotic ischemic stroke (LAAS). Methods 160 patients with acute mild LAAS admitted from June 2021 to June 2023 were consecutively included,and they were randomly divided into agatroban group (n=80) and control group (n=80).Patients were evaluated by the National Institutes of Health Stroke Scale (NIHSS),modified Rankin scale (mRS),mini mental state scale (MMSE),and transcranial doppler ultrasound (TCD) breath holding test before treatment and 7 days after treatment.The results were compared and analyzed. Results There was no significant difference in baseline data between the two groups of patients (P＞0.05).After 7 days of treatment,the incidence of progressive stroke in the control group was 33.8%,which was significantly higher than 15% in the agatroban group, and the difference was statistically significant (χ2=0.629,P=0.006).After 7 days of treatment,the NIHSS score of the agatroban group [2.0(1.0,3.0)] was lower than that of the control group [3.0(1.0,6.0)](P=0.017) and also lower than that of the before treatment [3.0(2.0,5.0)](P=0.002).After 7 days of treatment,the proportion of patients with mRS rating of 0-2 in the agatroban group was 83.8%,which was higher than 70.0% in the control group (P=0.040).After 7 days of treatment,the MMSE score of agatroban 24.96±3.37 was significantly higher than that of the control group 22.67±4.01 (P＜0.001) and before treatment 22.12±3.35 (P＜0.001).The average blood flow velocity before breath holding in argatroban group after 7 days of treatment 50.16±10.39cm/s was higher than that before treatment 44.16±10.63cm/s (P＜0.05). The average blood flow velocity after breath holding in the argatroban group after 7 days of treatment 65.41±13.20cm/s was higher than that before treatment 55.41±12.56cm/s (P＜0.05), and was also higher than that in the control group after 7 days of treatment 58.54±11.25cm/s (P=0.028). The breath holding index (BHI) 0.50±0.14 of argatroban group after 7 days of treatment was higher than that before treatment 0.37±0.10 (P＜0.001), and was also higher than that of the control group after 7 days of treatment 0.40±0.09 (P=0.001). Conclusion Agatroban can improve the cerebral blood flow regulation ability of patients with acute mild LAAS,reduce the occurrence of progressive stroke,and improve their limb and cognitive functions. |
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