目的 比較阿加曲班注射液和注射用尤瑞克林治療早期急性進(jìn)展性腦梗死的有效性、安全性。方法 選取2018年1月-2019年5月在通遼市醫(yī)院住院并在發(fā)病72 h內(nèi)進(jìn)展的92例急性腦梗死患者，隨機(jī)分成阿加曲班組和尤瑞克林組，每組各46例。阿加曲班組靜脈泵入阿加曲班注射液，60 mg/d治療2 d，然后10 mg/d治療5 d，早晚各1次，每次持續(xù)3 h。尤瑞克林組靜脈滴注注射用尤瑞克林0.15 PNA單位/d，前15 min內(nèi)控制滴速。兩組連續(xù)治療14 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分和Barthel指數(shù)評(píng)定量表（BI）評(píng)分。結(jié)果 治療后，阿加曲班組臨床有效率為82.6%，顯著高于尤瑞克林組的69.6%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。阿加曲班組在治療7、14 d后NIHSS評(píng)分較治療前明顯降低（P<0.05），而尤瑞克林組在治療14 d后才顯示出明顯改善（P<0.05）；治療后阿加曲班組NIHSS評(píng)分顯著低于尤瑞克林組同期，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。阿加曲班組在治療7、14 d后BI分值明顯升高（P<0.05），而尤瑞克林組則在治療14 d后與治療前比較才顯示出顯著差異（P<0.05）；治療后阿加曲班組BI分值顯著高于尤瑞克林組同期，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 阿加曲班注射液治療進(jìn)展性腦梗死早期進(jìn)展患者有較好的臨床療效，安全性好。

Objective To compare the efficacy and safety of argatroban and urinary kallidinogenase in treatment of progressive cerebral infarction. Methods Patients (92 cases) with progressive cerebral infarction progressed within 72 h and hospitalized in Tongliao Hospital from January 2018 to May 2019 were randomly divided into argatroban and urinary kallidinogenase groups, and each group had 46 cases. Patients in the argatroban group were iv pumped administered with Argatroban Injection, 60 mg/d for 2 d, then 10 mg/d for 5 d, once in the morning and evening and lasted for 3 h each time. Patients in the urinary kallidinogenase group were iv administered with Urinary Kallidinogenase for injection, 0.15 PNA U/d, controlled dropping speed in the first 15 min. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, NIHSS and BI scores in two groups were compared. Results After treatment, the clinical efficacy in the argatroban group was 82.6%, which was significantly higher than 69.6% in the urinary kallidinogenase group (P < 0.05). After treatment for 7 and 14 d, the NIHSS scores in the argatroban group were significantly decreased (P < 0.05), but which in the urinary kallidinogenase group were significantly improved after treatment for 14 d (P < 0.05). After treatment, NIHSS score in agajuban group was significantly lower than that in urinary kallidinogenase group, and there were differences between two groups (P < 0.05). After treatment for 7 and 14 d, the BI scores in argatroban group were significantly increased (P < 0.05), but the difference in the urinary kallidinogenase group compared with that before treatment was statistically significant after treatment for 14 d (P < 0.05). After treatment, BI scores in agajuban group was significantly higher than that in urinary kallidinogenase group, and there were differences between two groups (P < 0.05).Conclusion Agatraban has good clinical efficacy and safety in the treatment of early progressive cerebral infarction.

R971

內(nèi)蒙古自治區(qū)科技計(jì)劃項(xiàng)目（201702130）