楊玉華

[摘要]目的 探討阿加曲班聯(lián)合氯吡格雷治療大動(dòng)脈粥樣硬化性腦梗死的臨床效果。方法 將我院2015年4月～2016年8月收治的74例大動(dòng)脈粥樣硬化性腦梗死患者作為研究對(duì)象，以隨機(jī)為基本原則，將其分為對(duì)照組與觀察組，各37例。對(duì)照組使用氯吡格雷治療，在此基礎(chǔ)上，觀察組予以阿加曲班聯(lián)合治療。觀察兩組治療前后神經(jīng)功能缺損、日常生活能力、炎性因子水平以及不良反應(yīng)發(fā)生情況。結(jié)果 觀察組治療后神經(jīng)功能缺損評(píng)分為（4.71±0.63）分，日常生活能力評(píng)分為（81.82±2.33）分，白細(xì)胞介素-8水平為（0.36±0.28）ng/ml，腫瘤壞死因子-α水平為（0.40±0.19）ng/ml，均優(yōu)于對(duì)照組（P<0.05）；兩組的不良反應(yīng)發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 阿加曲班聯(lián)合氯吡格雷治療大動(dòng)脈粥樣硬化性腦梗死，可明顯改善神經(jīng)缺損及生活能力，且安全性較高。

[關(guān)鍵詞]氯吡格雷；阿加曲班；大動(dòng)脈粥樣硬化性腦梗死

[中圖分類(lèi)號(hào)] R743.9 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 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

腦梗死即為缺血性卒中，疾病誘發(fā)原因較多，主要是因機(jī)體腦組織發(fā)生局部供血障礙所致，患者腦組織發(fā)生缺氧、缺血性壞死會(huì)直接造成神經(jīng)功能缺損表現(xiàn)，可分為腔隙性、腦栓塞以及腦血栓形成腦梗死。此疾病起病較急，致死、致殘概率均較高，對(duì)人類(lèi)健康存在著嚴(yán)重威脅，急性腦梗死中大動(dòng)脈粥樣硬化性最為多見(jiàn)[1]，主要是由動(dòng)脈栓塞、低灌注等因素誘發(fā)。臨床多使用尿激酶溶栓治療，但因時(shí)間限制[2]，部分患者并不能及時(shí)實(shí)施溶栓治療，故尋找有效避免神經(jīng)缺損的方法極為重要。阿加曲班屬于凝血酶抑制劑，具有高度選擇性，臨床發(fā)現(xiàn)此藥物對(duì)于血凝塊相連或者游離的凝血酶均有效。本文探討阿加曲班聯(lián)合氯吡格雷治療大動(dòng)脈粥樣硬化性腦梗死的臨床效果，現(xiàn)報(bào)道如下。