目的 觀察阿加曲班治療急性腦梗死患者的臨床療效及安全性。方法 采用隨機、陽性對照研究，將42例急性腦梗死患者隨機分為對照組（20例）和治療組（22例）。治療組患者第1、2天每天用阿加曲班60 mg以500 mL生理鹽水稀釋，24 h持續(xù)靜脈泵注；其后的5 d用阿加曲班20 mg以100 mL生理鹽水稀釋，分早晚2次持續(xù)靜脈泵注，每次3 h，持續(xù)治療7 d。對照組患者第1、3天，每天用巴曲酶10 BU，以生理鹽水100 mL稀釋，第5天巴曲酶5 BU以生理鹽水100 mL稀釋，靜脈滴注，1 h內滴完；巴曲酶共間隔治療5 d。兩組患者在上述治療的基礎上均給予疏血通6 mL，1 次/d，靜脈滴注14 d，口服阿司匹林100 mg、阿托伐他汀20 mg，同時控制血壓、血糖、對癥等基礎治療，延續(xù)至出院后60 d。根據(jù)治療前、后14 d NIHSS評分評定即刻療效；根據(jù)治療前及治療后60 d mRS得分來評價患者臨床預后和生活自理能力，同時觀察兩組患者的不良反應。結果 兩組治療后14 d NIHSS評分均明顯低于治療前（P＜0.05），兩組比較差異無統(tǒng)計學意義；mRS評分治療組低于對照組，差異有統(tǒng)計學意義（P＜0.05）。兩組均未出現(xiàn)出血、皮疹等不良反應。結論 阿加曲班治療急性腦梗死，療效確切、安全，無明顯不良反應，患者后期生活自理能力優(yōu)于巴曲酶注射液。

Objective To evaluate the efficacy and safety of argatroban in the treatment of acute cerebral infarction. Methods The patients (42 cases) diagnosed as acute cerebral infarction were randomly divided into treatment (22 cases) and control (20 cases) groups, and the studies were positive controlled. The patients in the treatment group were treated with argatroban (60 mg diluted with 500 mL physiological saline) through 24 h continuous iv pump infusion on the first 2 d. The next 5 d they were treated with argatroban (20 mg diluted with 100 mL physiological saline), through continuous 3 h iv infusion twice daily in the morning and evening. They were treated for 7 d. The patients in the control group were treated with batroxobin (10 BU diluted with 100 mL physiological saline) on the days 1 and 3. On the day 5, they were injected with batroxobin (5 BU diluted with 100 mL physiological lsaline) through 1h iv drip. Every other day the therapy was continued for the patients until the day 5. The patients in the two groups on the basis of the above treatments were iv infused with Shuxuetong 6 mL, once daily for continuous 14 d, and po administered with Aspirin 100 mg and Atorvastatin 20 mg, while the blood pressure and blood sugar were controlled. The other basic symptomatic treatment was continued until 60 d after discharge. The effects were evaluated by index of NIHSS before and 14 d after the treatment. The clinical prognosis and self-care ability were evaluated by index of MRS before and 60 d after the treatment, while the side effects of the two groups were observed. Results Within 14 d after the treatment, the NIHSS scores of the two groups were significantly lower than those before the treatment (P < 0.05), and the difference between the two groups was not statistically significant. The mRS score in the treatment group was lower than that in the control group, with the significant difference (P < 0.05). The patients in the two groups had no bleeding, rash, or other side effects. Conclusion Argatroban used for the treatment of acute cerebral infarction is effective and safe with no significant side effects. The patients with argatroban treatment have better self-care ability in the later life than those with Batroxobin Injection.