Abstract：Objective: To analyze the effect of argatroban on hemorheology, neurological deficit and activity of daily life in patients with posterior circulation cerebral infarction. Methods: A total of 120 patients with posterior circulation cerebral infarction admitted to our hospital from September 2017 to September 2019 were randomly divided into two groups by simple random grouping method: the control group was treated in conventional manner and the treatment group was administered argatroban + conventional. The hemorheology indexes, National Institutes of Health Stroke Scale (NIHSS) and the modified Barthel Index (MBI) of the two groups were compared before and after treatment. During the treatment, thromboelastography and coagulation function were performed in the treatment group to evaluate the effect of agatraban on the improvement of coagulation function. Results: Three months after treatment, Hct and whole blood relative shear rate index (high shear) in the control group were significantly reduced compared with corresponding data before treatment (P< 0.05), but there was no significant change in plasma viscosity and the shear rate of whole blood viscosity (high shear). The Hct, plasma viscosity, whole blood relative shear rate index (high shear) and shear rate of whole blood viscosity (high shear) were significantly reduced compared with corresponding data before treatment, and each index after treatment was significantly reduced compared with control group (P< 0.05). The NIHSS scores of the two groups decreased significantly after 3 months of treatment, and the decrease range of the treatment group after treatment was more significant compared with control group (P< 0.05); compared with corresponding data before treatment, the MBI scores of the two groups after 3 months of treatment were significantly increased, and the increase range of the treatment group after treatment was more significant compared with control group (P< 0.05). The prothrombin time, prothrombin time and activated partial thromboplastin time (APTT) in the treatment group were significantly prolonged compared with control group at 60 mg / d, while the prothrombin time, prothrombin time and APTT were significantly shorter at 30 mg / d and 2 d after stopping treatment. The comparison of coagulation function indexes at different time points was statistically significant (P< 0.05). After 60 mg / d, the coagulation index and the activity of coagulation factors in the treatment group decreased significantly, while after 30 mg / d and 2 days of withdrawal, the coagulation index and the activity of coagulation factors returned to the normal range (P< 0.05). Conclusion: The application of argatroban can effectively improve the hemorheology and coagulation function of patients with post circulation cerebral infarction, reduce the degree of neurological deficit, improve the ability of daily life activities, and has good safety, so it is worth clinical application.
柳春雨, 武建宏, 杨晓丹. 阿加曲班对后循环脑梗死患者神经功能缺损评分Barthel指数和血液流变学指标的影响[J]. 河北医学, 2020, 26(7): 1079-1083.
LIU Chunyu, WU Jianhong, YANG Xiaodan. The Effect of Argatroban on Neurological Deficit Score Barthel Index and Hemorheology in Patients with Posterior Circulation Cerebral Infarction. HeBei Med, 2020, 26(7): 1079-1083.
[1] 何旭,钱夕元,阮彤,等.基于贝叶斯网络的心血管疾病与其他慢性病因果关系分析[J].郑州大学学报(医学版),2019,54(4):512~517. [2] Wang F, Hu XY, Wang T, et al. Clinical and imaging features of vertebrobasilar dolichoectasia combined with posterior circulation infarction: A retrospective case series study[J]. Medicine (Baltimore),2018,97(48):e13166. [3] 中华医学会神经病学分会,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2018[J].中华神经科杂志,2018,51(9):666~682. [4] Lyden P.Using the National Institutes of Health Stroke Scale: A cautionary tale[J].Stroke,2017, 48(2):513~519. [5] Ohura T, Hase K, Nakajima Y, et al.Validity and reliability of a performance evaluation tool based on the modified Barthel Index for stroke patients[J].BMC Med Res Methodol,2017,17(1):131. [6] Sparaco M, Ciolli L, Zini A. Posterior circulation ischemic stroke-a review part II: imaging and acute treatment[J]. Neurol Sci,2019,40(10):2007~2015. [7] Gorgui J, Gasbarrino K, Georgakis MK, et al. Circulating adiponectin levels in relation to carotid atherosclerotic plaque presence, ischemic stroke risk, and mortality: A systematic review and meta-analyses[J]. Metabolism,2017,69(1): 51~66. [8] Hirasaki Y, Yamamoto Y, Nakamura T, et al. Rotational thromboelastometry for coagulation management during cardiopulmonary bypass using argatroban[J].Cardiothorac Vasc Anesth, 2019,33(7):1977~1982. [9] Chen L, Cao S, Yang J. Argatroban plus aspirin versus aspirin in acute ischemic stroke[J]. Neurol Res,2018,40(10):862~867. [10] 解建国,刘峰.阿加曲班联合阿替普酶静脉溶栓治疗急性脑梗死的疗效及脑血管储备功能的影响[J].河北医学,2018,24(10):1602~1606. [11] Nagakane Y, Tanaka E, Ashida S, et al. Safety of dual antiplatelet therapy with argatroban in patients with acute ischemic stroke[J]. Brain Nerve,2018,70(5): 557~562. [12] 谷聚贤,李易明,安泽鑫,等.阿加曲班对早期急性脑梗死患者溶栓后的疗效分析[J].河北医科大学学报,2019,40(8):886~889.
2020, Vol. 26 
冀公网安备13080202000677号