2024 年第 3 期 第 19 卷

阿加曲班对小动脉闭塞型脑卒中患者早期神经功能恢复的影响研究

The effect of agatroban on early neurological function recovery in patients with small artery occlusive stroke

作者：朱江胡绍福陈启航窦志杰

英文作者：Zhu Jiang Hu Shaofu Chen Qihang Dou Zhijie

单位：承德医学院附属医院神经内科，承德067000

英文单位：Department of Neurology Affiliated Hospital of Chengde Medical University Chengde 067000 China

关键词：脑卒中；缺血性；小动脉闭塞；阿加曲班

英文关键词：Stroke;Ischemic;Smallarteryocclusionstroke;Agatroban

• 摘要：

• 目的 探讨阿加曲班对小动脉闭塞型脑卒中患者早期神经功能恢复的影响。方法 纳入2021年6月至2022年12月承德医学院附属医院神经内科收治的缺血性脑卒中患者120例，以随机数字表法将患者分为阿加曲班组和双抗组，各60例。所有患者均给予基础治疗，在此基础上，阿加曲班组给予阿加曲班注射液持续静脉泵入治疗，双抗组给予阿司匹林肠溶片和氯吡格雷口服治疗，2组治疗周期均为7 d。比较2组临床疗效、神经功能、日常生活能力、血清细胞因子水平、血液流变学及安全性指标。结果 阿加曲班组总有效率高于双抗组［81.7%（49/60）比65.0%（39/60）］，差异有统计学意义（P<0.05）。治疗后，阿加曲班组美国国立卫生研究院卒中量表评分低于双抗组，日常生活活动能力量表评分高于双抗组［（0.81±0.20）分比（1.34±0.37）分、（87±5）分比（78±4）分］,差异均有统计学意义（均P<0.001）。治疗后2组白细胞介素6、肿瘤坏死因子α、高敏C反应蛋白、全血黏度切变率、相对血液黏度切变率、血浆黏度、纤维蛋白原水平均低于治疗前，且阿加曲班组均低于双抗组，差异均有统计学意义（均P＜0.05）。2组不良反应总发生率差异无统计学意义（P＞0.05）。结论 阿加曲班对小动脉闭塞所致缺血性脑卒中疗效显著，能促进患者早期神经功能恢复，提高日常生活独立能力，降低炎症因子水平，改善血液流变学，且安全性好。

• Objective To investigate the effect of agatroban on early neurological function recovery in patients with small artery occlusive stroke. Methods Totally 120 patients with ischemic stroke admitted to Department of Neurology, Affiliated Hospital of Chengde Medical University from June 2021 to December 2022 were enrolled. Patients were divided into agatrobangroup and dual antibody group using the random number table method, with 60 cases in each group. All patients were given basic treatment. On this basis, the agatroban group was given continuous intravenous infusion of agatroban injection, while the dual antibody group was given aspirin enteric coated tablets and clopidogrel oral treatment. The treatment period for both groups was 7 d. Clinical efficacy, neurological function, daily living ability, serum cytokine levels, hemorheology, and safety indicators were compared between the two groups. Results The total effective rate of the agatroban group was higher than that of the dual antibody group［81.7%(49/60) vs 65.0%(39/60)］(P<0.05). After treatment, the National Institutes of Health Stroke Scale score of agatroban group was lower than that of the dual antibody group, while the Activity of Daily Living Scale score was higher than that of the dual antibody group［(0.81±0.20) vs (1.34±0.37), (87±5) vs (78±4)］(both P<0.001). After treatment, the levels of interleukin-6, tumor necrosis factor-α, high-sensitivity C-reactive protein, whole blood viscosity shear rate, relative blood viscosity shear rate, plasma viscosity and fibrinogen in the two groups were all lower than those before treatment, and levels of the agatroban group were lower than those of the dual antibody group(all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Agatroban is effective in the treatment of ischemic stroke caused by small artery occlusive stroke. It can promote the recovery of patients′ early neurological function, improve the independence of daily life, reduce the level of inflammatory factors and improve hemorheology, and has good safety.