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| Clinical Efficacy Analysis of Argatroban Combined with Butylphthalide in the Treatment of Acute Ischemic Cerebral Infarction in the Elderly |
| WANG Jihui, ZHOU Changhu, CHEN Lingdong |
| The Affiliated Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221000, China |
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Abstract Objective: To observe and analyze the clinical efficacy of argatroban combined with butylphthalide in the treatment of acute ischemic cerebral infarction in elderly patients, and to study its safety. Methods: Using 130 cases of clearly diagnosed acute ischemic cerebral infarction in the elderly admitted to our hospital from March 2019 to September 2021 as the study subjects, a simple randomized grouping method was used with a random number table, in which 65 patients in the control group were treated with argatroban (day 1 and 2, 60 mg/d argatroban 24 h continuous intravenous pumping, day 3, 4 and 5, argatroban 10mg/d, 3 h /The Barthel Index, NIHSS and mRS scores were measured before and after treatment, and the R-value, K-value, α-angle and MA-value of the thromboelastogram were measured in 65 patients in the test group (same as the control group). MA values and other indicators were measured. The efficacy of the treatment in both groups was calculated and adverse effects such as dizziness, loss of appetite and nausea during the treatment were counted. Results: Before treatment, the differences in NIHSS scores, Barthel Index scores and mRS scores of patients treated by different regimens were not statistically significant (P>0.05); after treatment, the NIHSS scores and mRS scores of patients in both groups were significantly lower, and the differences in NIHSS scores (8.34±1.24) and mRS scores (1.60±0.12) of patients in the test group before and after treatment were significantly higher than those in the control group (5.07±1.14, 0.73±0.09), with statistically significant differences (P<0.05); the Barthel Index scores of patients were significantly higher after treatment, and the difference in Barthel Index scores before and after treatment was significantly higher in the test group (17.58±5.41) than that in the control group (9.70±4.22), with statistically significant differences (P<0.05). The difference was statistically significant (P<0.05). Before treatment, there was no significant difference in the thromboelastography indexes (R value, K value, α angle and MA value) between the two groups (P>0.05); after treatment, R value and K value increased significantly, α angle and MA value decreased significantly in the two groups, and α angle was smaller in the test group than in the control group, the increase in R value before and after treatment was significantly lower in the test group (0.16±0.12) than in the control group (0.20±0.11) The increase in R-value (0.16±0.12) was significantly lower than that of the control group (0.20±0.11), and the decrease in alpha angle (9.40±0.88) was significantly higher than that of the control group (7.46±0.75) before and after treatment. The overall effective rate of patients in the test group was 90.77%, which was significantly higher than that of patients in the control group (70.77%), and the difference was statistically significant (P<0.05). The main adverse reactions of patients were dizziness, loss of appetite and nausea, with a total of 5 cases (7.69%) in the trial group and 4 cases (6.15%) in the control group (P>0.05). Conclusion: Agatroban combined with butylphthalide in the treatment of acute ischaemic cerebral infarction in the elderly significantly reduced the NIHSS score and mRS score of the patients, and the Barthel Index score of the patients was significantly higher, which had a better prognosis than treatment with agatroban alone and facilitated clinical treatment.
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2023, Vol. 29 
