The Efficacy And Safety Of Argatroban Combined With Aspirin In The Treatment Of Progressive Ischemic Stroke

Objectives To evaluate the efficacy and safety of argatroban combined with aspirin in the treatment of progressive ischemic stroke(PIS)by comparing the short-term clinical efficacy and long-term prognosis of patients with PIS treated with aspirin,so as to seek a more effective and safe treatment for PIS patients.Methods According to TOAST classification,168 patients with PIS diagnosed as large-artery atherosclerosis(LAA)within 48 hours after onset in our hospital from October 2017 to October 2019 were selected.According to the random number table,they were divided into two groups: argatroban group(test group)and aspirin group(control group).Among them,86 cases in the control group were given aspirin treatment,and 82 cases in the study group were given agatroban combined with aspirin treatment.The dose of argatroban was 60 mg/d for 2 consecutive days,then decreased after 3 to 7 days,It was 20 mg/d combined with aspirin.The other treatment methods were the same,the treatment time was 14 days.Both groups of patients continued to take aspirin for 3 months.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of the two groups before and after treatment,and then the total effective rate was evaluated according to the degree of improvement of neurological function after 14 days of treatment,and the short-term efficacy of each regimen was evaluated by the total effective rate,and the safety was evaluated by the incidence of adverse events recorded in the two groups during the treatment period.The long-term prognosis of the patients was evaluated by the modified Rankin Scale(m RS)during 3 month follow up.At the same time,patients with LAA type PIS were classified by OCSP to further compare the clinical efficacy of argatroban combined with aspirin in the treatment of anterior and posterior circulation infarction.Results 1 After 7 days and 14 days of treatment,the NHISS scores of the test group and the control group were significantly lower than before treatment,the difference was statistically significant(P<0.05).2 After 7 and 14 days of treatments,the NHISS score of the test group was lower than that of the control group,and the difference between the two groups was statistically significant(P=0.035,P=0.026).3 Comparison of the total clinical effective rate between the two groups: the total effective rate of the test group was 70.7%,while that of the control group was 52.3%.The total effective rate in the test group was better than that of the control group,and the difference was statistically significant(P=0.014).4 The rate of good prognosis in the test group was better than that in the control group after treatment for 3 months,and the difference between the two groups was statistically significant(P=0.033).5 The treatment effective rate of anterior circulation infarction in the test group was 75.0%,while that in the control group was 62.5%.There was no significant difference in the treatment effective rate of anterior circulation infarction between the two groups(P=0.216).The treatment effective rate of posterior circulation infarction in the test group was 65.8%,while that in the control group was 43.5%.The treatment effective rate of posterior circulation infarction in the test group was higher than that in the control group,and the difference was statistically significant(P=0.041).6 No symptomatic intracranial hemorrhage occurred in both groups during the treatment period.In terms of additional adverse events,the incidence of adverse events in the test group was 6.0%,while that in the control group was 4.7%.There was no significant differences between the two groups(P=0.677).Conclusions 1 The dose of argatroban is 60mg/d for 1 to 2 days,and the reduction to 20mg/d after 3 to 7 days combined with aspirincan significantly improve the symptoms of short-term neurological deficits in patients with progressive ischemic stroke,and its clinical effect is better than that of traditional aspirin therapy.2 Compared with the traditional antiplatelet drug aspirin,the dose of argatroban is 60mg/d for 1 to 2 days combined with aspirin,and it is reduced to 20mg/d after 3 to 7 days for the treatment of progressive ischemic stroke without increasing the occurrence of adverse events such as bleeding,so it is safe.3 Argatroban combined with aspirin has a good effect on progressive ischemic stroke patients with posterior circulation infarction.Figure0;Table 9;Reference 82...