目的 探討阿加曲班聯(lián)合吡拉西坦對(duì)急性缺血性卒中患者認(rèn)知功能、肢體功能的影響。方法 回顧性選取邢臺(tái)市第三醫(yī)院于2021年12月-2022年7月收治住院的80例急性缺血性卒中患者為研究對(duì)象，根據(jù)治療方法將患者分為對(duì)照組和試驗(yàn)組，兩組各40例。兩組患者均給予常規(guī)治療，對(duì)照組在常規(guī)治療基礎(chǔ)上給予注射用吡拉西坦（注射用吡拉西坦8 g加入到5%氯化鈉注射液250 mL中）靜脈滴注，每天1次，療程為14 d；試驗(yàn)組在對(duì)照組治療的基礎(chǔ)上加用阿加曲班注射液治療，第1～2天60 mg阿加曲班注射液用0.9%氯化鈉注射液稀釋后持續(xù)輸液泵輸液48 h，第3～7天將10 mg阿加曲班注射液加入0.9%氯化鈉注射液20 mL中持續(xù)輸液泵輸液持續(xù)3 h，每天2次，用藥7 d，其余治療方案同對(duì)照組。分別于治療前及治療后3、6個(gè)月對(duì)兩組患者進(jìn)行蒙特利爾認(rèn)知評(píng)估量表（MoCA）、簡(jiǎn)易智力狀態(tài)檢查量表（MMSE）、改良式肢體運(yùn)動(dòng)功能量表（Fugl-Meyer）以及日常生活能力量表（ADL）評(píng)分，同時(shí)記錄兩組的不良反應(yīng)發(fā)生情況。結(jié)果 治療前兩組患者M(jìn)oCA、MMSE、Fugl-Meyer及ADL評(píng)分比較，差異均無統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后3、6個(gè)月兩組患者M(jìn)oCA、MMSE、Fugl-Meyer及ADL評(píng)分均較同組治療前顯著提高（P＜0.05），且試驗(yàn)組各項(xiàng)評(píng)分均顯著高于對(duì)照組（P＜0.05）。治療期間兩組患者不良反應(yīng)事件發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。結(jié)論 阿加曲班聯(lián)合吡拉西坦治療能顯著改善急性缺血性卒中患者的認(rèn)知功能以及肢體功能，在保證療效的同時(shí)并未增加出血等不良反應(yīng)發(fā)生風(fēng)險(xiǎn)。

Objective To investigate the effect of argatroban combined with piracetam on cognitive function and limb function in patients with acute ischemic stroke. Methods A total of 80 patients with acute ischemic stroke admitted to Xingtai Third Hospital from December 2021 to July 2022 were selected as the study subjects. According to the treatment methods, the patients were divided into control group and experimental group, with 40 patients in each group. Patients in both groups were treated with routine therapeutic drugs, while patients in the control group were given intravenous drip of Piracetam for Injection (8 g of Piracetam for Injection was added to 250 mL of 5% Sodium Chloride Injection) on the basis of routine treatment, once a day, for 14 days. On the basis of the treatment of the control group, patients in the experimental group were treated with Argatroban Injection. On the first to second days, 60 mg of Argatroban Injection was diluted with 0.9% Sodium Chloride Injection and then continued infusion with infusion pump for 48 hours. On the third to seventh days, 10 mg of Argatroban Injection was added into 20 mL of 0.9% Sodium Chloride Injection and continued infusion with infusion pump for three hours, twice a day, and the total course of treatment was seven days. The other treatment schemes were the same as the control group. The patients in the two groups were scored with the Montreal Cognitive Assessment Scale (MoCA), the Simple Mental State Examination Scale (MMSE), the Modified Limb Motor Function Scale (Fugl-Meyer) and the Activity of Daily Living Scale (ADL) before and three and six months after treatment, respectively, and the adverse reactions in the two groups were recorded. Results There was no significant difference in MoCA, MMSE, Fugl-Meyer and ADL scores between the two groups before treatment (P> 0.05). Three and six months after treatment, the scores of MoCA, MMSE, Fugl-Meyer and ADL of patients in the two groups were significantly higher than those before treatment (P< 0.05), and the scores in the experimental group were significantly higher than those in the control group (P< 0.05). There was no significant difference in the incidence of adverse events between the two groups during treatment (P> 0.05). Conclusion Argatroban combined with piracetam can significantly improve the cognitive function and limb function of patients with acute ischemic stroke, without increasing the risk of bleeding and other adverse reactions while ensuring the efficacy.

R971