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[1]吴平,王念,秦磊.阿加曲班对后循环梗死患者脑血流动力学的影响[J].医学研究与战创伤救治(原医学研究生学报),2019,21(6):612-615.[doi:10.3969/j.issn.1672-271X.2019.06.013]
 WU Ping,WANG Nian,QIN Lei.Effect of argatroban on cerebral hemodynamics in patients with posterior circulation infarction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(6):612-615.[doi:10.3969/j.issn.1672-271X.2019.06.013]
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阿加曲班对后循环梗死患者脑血流动力学的影响()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年6期
页码:
612-615
栏目:
临床研究
出版日期:
2019-11-14

文章信息/Info

Title:
Effect of argatroban on cerebral hemodynamics in patients with posterior circulation infarction
文章编号:
1672-271X(2019)06-0612-04
作者:
吴平 王念 秦磊
225300泰州,泰州市中医院脑病科
Author(s):
WU Ping WANG Nian QIN Lei
(Department of Encephalopathy, Taizhou Traditional Chinese Medicine Hospital,Taizhou 225300,Jiangsu,China)
关键词:
阿加曲班 脑梗死 血流动力学 美国国立卫生研究院卒中量表
Keywords:
agaquban cerebral infarction hemodynamics National Institute of Health stroke scale(NIHSS)
分类号:
R743.32
DOI:
10.3969/j.issn.1672-271X.2019.06.013
文献标志码:
A
摘要:
目的 观察阿加曲班对后循环梗死患者脑血流动力学的影响。 方法 回顾性分析2014年1月至2018年7月在泰州市中医院脑病科住院的80例后循环梗死患者临床资料,按治疗方法不同分为对照组和阿加曲班组各40例。对照组采用抗血小板聚集、降脂、稳定斑块、调控血压、改善循环治疗。阿加曲班组在对照组治疗基础上加用阿加曲班联合治疗。比较2组治疗前和治疗后14 d患者的左右椎动脉、基底动脉在收缩期峰值血流速度(Vs)、舒张期血流速度(Vd)及平均血流速度(Vm),采用美国国立卫生研究院卒中量表(NIHSS)对治疗前和治疗14 d后患者的神经功能缺损评分进行对比,分析2组治疗28 d后的临床疗效。 结果 治疗14 d后阿加曲班组患者的脑血流动力学较对照组明显改善(P<0.05),治疗14 d后阿加曲班组患者的NIHSS评分较对照组明显下降[(10.33±3.41)分 vs (12.33±3.53)分,P<0.05]。治疗28 d后阿加曲班组较对照组临床有效率明显提高(80.00% vs 57.50%,P<0.05)。 结论 阿加曲班能改善后循环梗死患者脑血流动力学,改善神经功能障碍,在临床值得推广。
Abstract:
Objective To observe the effect of agatraban on cerebral hemodynamics in patients with posterior circulation infarction. Methods The clinical data of 80 patients with posterior circulation infarction who were hospitalized in the Department of encephalopathy of Taizhou Hospital of traditional Chinese medicine from January 2014 to July 2018 were analyzed retrospectively. According to different treatment methods, they were divided into control group and agaquban group with 40 cases each. The control group was treated with antiplatelet aggregation, lipid-lowering, plaque stabilization, blood pressure regulation and circulation improvement. Agaquban group was treated with agaquban combined with agaquban on the basis of the control group. The peak systolic velocity (VS), diastolic velocity (VD) and mean velocity (VM) of left and right vertebral artery and basilar artery were compared before and 14 days after treatment. The NIHSS was used to compare the neurological deficit scores of the patients before and after treatment for 14 days, and the clinical effects of the two groups after treatment for 28 days were analyzed. Results After 14 days of treatment, thehemodynamics of the patients in agaquban group was significantly improved than that in the control group (P<0.05). After 14 days of treatment, the NIHSS score of the patients in agaquban group was significantly lower than that in the control group [(10.33±3.41) vs (12.33±3.53), P<0.05]. After 28 days of treatment, the clinical effective rate of agatroban group was significantly higher than that of the control group (80.00% vs 57.50%, P<0.05). Conclusion Agatraban can improve cerebral hemodynamics and neurological dysfunction in patients with posterior circulation infarction, which is worth popularizing in clinic.

参考文献/References:

1 王彬,杨丽丽,贾红娟,等.阿加曲班注射液治疗急性脑梗死患者55例的疗效观察[J].中国伤残医学,2015,23(1):107-108.
2 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊疗指南撰写组.中国急性缺血性脑卒中诊疗指南 2010[J].中华神经科杂志,2010,43(9)146-148.
3 周斌,陆丽芬,王杭芳.急诊室急性脑梗塞rtPA溶栓治疗体会[J].按摩与康复医学,2014,30(9):125-126.
4 孔玉明.MRI与CT在老年多发性脑梗死病人诊断中的临床结果比较[J].临床和实验医学杂志,2016,15(22):2267-2269.
5 温玲玲.脑梗死采用脑电图和经颅多普勒诊断的早期诊断价值解析[J].中国医学工程,2015,23(4):104.
6 张忠敏,郭艳芹,韩璎,等.急性脑梗死侧支循环建立的神经影像学评估[J].医学研究生学报,2015,28(1):85-86.
7 中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南 2014[J].中华神经科杂志,2015,48(4):246-247.
8 EscolarG,BozzoJ,MaragallS.Argatroban: a direct thrombin inhibitor with reliable and predictable anticoagulant actions[J].Drugs Today,2006,42(2): 223-225.
9 ChenB,FriedmanB,Whitney MA,et al.Thrombin activity associated with neuronal damage during acute focal ischemia[J].J Neurosci,2012,32(5): 7622-7624.
10 De La RosaX,CerveraA,KristoffersenAK,et al.Mannose-Binding lectin promotes local microvascular thrombosis after transient brain ischemia in mice[J].Stroke,2014,45(8): 1453-1456.
11 MarukiY,OnodaA,MatsuzakiM, et al.A specific thrombin inhibitor (argatroban) ameliorated cerebral blood flow in the patientswith acute cerebral infarction[J].Keio J Med, 2000, 49(Suppl 1): A138-140.
12 吉智,范秀博.注射用红花黄色素联合阿加曲班治疗急性脑梗死的临床研究[J].现代药物与临床,2016,31(2):158-162.
13 高志强,张鹏,戴瑛,等.联合抗栓治疗急性缺血性脑卒中的近期疗效和安全性[J].南京医科大学学报(自然科学版),2015,35(8):1152-1154.
14 SiegmundaR,BoeraK,PoeschelK, et al.Comparison of the ecar in chromogenic assay and different APTT assays for the measurement of argatroban concentrations in plasma from healthy individuals and from coagulation factor deficient patients [J].Thromb Res,2008,123(1):159-165.
15 王彦云,王珩.阿加曲班治疗急性脑梗死的临床研究进展[J].中西医结合心脑血管病杂志,2015,13(8):995-997.
16 许俊堂. 阿加曲班临床应用的进展[J]. 血栓与止血学,2007,13(4):180-182.
17 沈明强,吴冠会,董晓峰,等. 阿加曲班抗凝治疗急性脑梗死的疗效观察[J].临床神经病学杂志,2017,30(2):141-143.
18 HuaY,TangLL,FewelME, et al.Systemic use of argatroban reduces tumor mass,attenuates neurological deficits and prolongs survival time in rat glioma models[J].Acta Neurochir Suppol,2005,95(95):403-406.
19 董薇薇.阿加曲班治疗急性脑梗死疗效观察[J].中国实用医药,2013,8(5):70-71.
20 周楚瑶,薛凡.阿加曲班在连续性肾脏替代治疗中的疗效观察[J].东南国防医药,2013,15(6):594-595.

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备注/Memo

备注/Memo:
收稿日期:2019-04-18
更新日期/Last Update: 2019-11-15