目的 探討杏芎氯化鈉注射液聯(lián)合阿加曲班治療急性腦梗死的臨床療效。方法 選取2022年6月—2023年7月延安大學(xué)咸陽醫(yī)院收治的急性腦梗死患者108例，按照隨機(jī)數(shù)字表法分為對照組（54例）和治療組（54例）。對照組患者靜脈泵注阿加曲班注射液，起始2 d劑量為2.5 mg/h，24 h持續(xù)，之后劑量為10 mg/次，在3 h左右完成靜脈滴注，2次/d，此劑量連續(xù)使用5 d。治療組患者在對照組基礎(chǔ)上靜脈滴注杏芎氯化鈉注射液，100 mL/次，1次/d。兩組患者治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者可溶性血管細(xì)胞黏附因子-1（sVCAM-1）、白細(xì)胞介素-1β（IL-1β）、D-二聚體和纖維蛋白原水平，及美國國立衛(wèi)生研究院卒中量表（NIHSS）評分和90 d預(yù)后情況。結(jié)果 治療后，治療組總有效率為94.44%，比對照組的81.48%明顯升高（P＜0.05）。治療后，兩組sVCAM-1、IL-1β、D-二聚體、纖維蛋白原水平和NIHSS評分明顯降低（P＜0.05），且治療組明顯低于對照組（P＜0.05）。治療組90 d預(yù)后良好率為88.89%，對照組為74.07%，兩組比較差異具有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 杏芎氯化鈉注射液聯(lián)合阿加曲班對急性腦梗死的治療效果以及安全性均較為理想，可改善體內(nèi)炎癥反應(yīng)、血液高凝狀態(tài)以及神經(jīng)功能。

Objective To explore the therapeutic effect of Xingxiong Sodium Chloride Injection combined with agatroban in treatment of acute cerebral infarction. Methods Patients (108 cases) with acute cerebral infarction in Xianyang Hospital of Yan’an University from June 2022 to July 2023 were divided into control (54 cases) and treatment (54 cases) group according to the random number table method. Patients in the control group were iv administered with Argatroban Injection, the dose was 2.5 mg/h in the first 2 d, and then the dose was 10 mg/time, intravenous drip was completed in about 3 h, twice daily, and the dose was used continuously for 5 d. Patients in the treatment group were iv administered with Xingxiong Sodium Chloride Injection on the basis of the control group, 100 mL/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the levels of sVCAM-1, IL-1β, D-dimer and fibrinogen, NIHSS sores and 90 day prognosis in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.44%, which was significantly higher than that of the control group (81.48%,P < 0.05). After treatment, the levels of sVCAM-1, IL-1β, D-dimer, fibrinogen, and NIHSS scores in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). The rate of good prognosis at 90 days in the treatment group was 88.89%, while that in the control group was 74.07%, there was significant difference between two groups (P < 0.05). Conclusion Agatroban combined with Xingxiong Sodium Chloride Injection is effective and safe in the treatment of acute cerebral infarction, which can improve inflammatory reaction, blood hypercoagulable state and neurological function in vivo.

R971

陜西省科學(xué)技術(shù)研究發(fā)展計劃項目（2020JM4149）