目的 探討阿加曲班對下肢動脈硬化閉塞合并急性血栓形成的老年患者的治療效果以及治療過程中對凝血功能的影響。方法 回顧性選取2018年5月—2021年10月民航總醫(yī)院收治的下肢動脈硬化閉塞合并急性血栓形成的年齡≥65歲的老年患者67例，隨機(jī)分為對照組（n＝33）和試驗組（n＝34），對照組采用那屈肝素鈣注射液（每次4 100 U，每12小時給藥1次）抗凝，試驗組采用阿加曲班注射液（20 mg加入到160 mL 0.9%氯化鈉注射液中，泵速20 mL·h⁻¹，每天2次，2次之間間隔2 h）抗凝，兩組患者均連續(xù)治療7 d。比較兩組患者治療效果、凝血功能指標(biāo)變化及治療過程中并發(fā)癥及不良反應(yīng)發(fā)生的情況。結(jié)果 治療后，對照組總有效率為78.79%；試驗組總有效率為82.35%，兩組總有效率比較，差異無統(tǒng)計學(xué)意義（P＞0.05）。與治療前相比，治療后兩組患者D-二聚體、纖維蛋白原（FBG）、血小板計數(shù)（PLT）水平均顯著降低（P＜0.05），活化部分凝血活酶時間（APTT）、凝血酶原時間（PT）明顯延長（P＜0.05），血漿黏度及紅細(xì)胞比積均顯著降低（P＜0.05）；治療第3天試驗組D-二聚體水平顯著低于對照組（P＜0.05）；治療后試驗組FBG、血漿黏度、紅細(xì)胞比積水平降低程度，APTT、PT延長程度與對照組比較差異無統(tǒng)計學(xué)意義（P＞0.05）。試驗組不良反應(yīng)發(fā)生率顯著低于對照組（P＜0.05）。結(jié)論 阿加曲班治療下肢動脈硬化閉塞合并急性血栓形成的老年患者臨床療效顯著，對患者D-二聚體、FBG、APTT、PT指標(biāo)改善有積極作用，并可調(diào)節(jié)血液流變學(xué)狀態(tài)，安全性高。

Objective To observe the therapeutic effect of argatroban in elderly patients with lower extremity arteriosclerosis occlusion complicated with thrombosis and its effect on coagulation function. Methods From May 2018 to October 2021, 67 elderly patients with lower extremity arteriosclerosis occlusion complicated with acute thrombosis aged ≥ 65 years were retrospectively selected and randomly divided into control group (n = 33) and experimental group (n = 34). Patients in the control group were anticoagulated with Nadroparin Calcium Injection (4 100 U each time, once every 12 h), Patients in the experimental group were treated with Argatroban Injection (20 mg was added to 160 mL 0.9% Sodium Chloride Injection, the pump speed was 20 mL·h⁻¹, twice a day, with an interval of two hours). The patients in both groups were treated for seven days. The therapeutic effect, changes of coagulation function indexes, complications and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the control group was 78.79%, the total effective rate of the experimental group was 82.35%. There was no significant difference between the two groups (P > 0.05). Compared with before treatment, the levels of D-dimer, fibrinogen (FBG) and platelet count (PLT) in two groups decreased significantly (P < 0.05), the levels of activated partial thromboplastin time (APTT) and prothrombin time (PT) in two groups increased significantly (P < 0.05), and the plasma viscosity and hematocrit in two groups decreased significantly (P < 0.05). On the third day of treatment, the level of D-dimer in the experimental group was significantly lower than that in the control group (P < 0.05). After treatment, there was no significant difference between the experimental group and the control group in the decrease of FBG, plasma viscosity and hematocrit, and the increase of APTT and PT (P > 0.05). The incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion Argatroban is effective in the treatment of elderly patients with lower extremity arteriosclerosis occlusion complicated with acute thrombosis. It has a positive effect on the improvement of D-dimer, FBG, APTT and PT, and can regulate the state of hemorheology with high safety. K

R971