目的 觀察阿加曲班在治療輕型缺血性腦卒中的療效和安全性。方法 回顧性選擇2022年1月—2022年12月于南方醫(yī)科大學(xué)附屬何賢紀(jì)念醫(yī)院神經(jīng)內(nèi)科因急性缺血性腦卒中住院的分類為輕型卒中［美國國立衛(wèi)生研究院卒中量表（NIHSS）小于9分］患者61例為研究對象，根據(jù)治療期間有無規(guī)范使用阿加曲班藥物治療分為試驗(yàn)組和對照組，對照組按照常規(guī)急性缺血性腦卒中診療方案治療，即在時(shí)間窗內(nèi)對于符合靜脈溶栓和機(jī)械取栓的患者進(jìn)行急性期治療，在非時(shí)間窗內(nèi)就診的患者進(jìn)行抗血小板、改善循環(huán)、監(jiān)控血壓、血糖等支持治療；試驗(yàn)組在常規(guī)治療基礎(chǔ)上給予阿加曲班注射液治療，即發(fā)病48 h內(nèi)的患者在入院后24 h內(nèi)以5 mL·h^-1持續(xù)靜脈泵入，隨后以每天20 mg，分2次以0.9%氯化鈉注射液250 mL稀釋后靜脈滴注，療程7 d。分別記錄患者出院時(shí)NIHSS評分及入院與出院NIHSS評分差值，同時(shí)記錄入院和出院時(shí)的改良Rankin（mRS）評分，所有患者均進(jìn)行系統(tǒng)性檢查并進(jìn)行TOAST分型。記錄住院期間的血小板減少、便血或顱內(nèi)出血等不良事件發(fā)生情況。結(jié)果 試驗(yàn)組患者住院期間NIHSS評分較對照組改善明顯（P<0.05）；但出院時(shí)mRS評分良好率（mRS評分為0～2分患者占比）兩組比較差異不明顯（P>0.05）；兩組患者均無不良事件發(fā)生。結(jié)論 阿加曲班可以改善輕型缺血性卒中患者的臨床癥狀并安全性較高。

Objective To analyze the efficacy and safety of argatroban in patients with mild ischemic stroke to provide more effective treatments and to improve prognosis. Methods Retrospective analysis of 61 patients hospitalized for acute cerebral infarction and classified in mild stroke (NIHSS score is in less than 9) in the Department of Neurology of HeXian Memorial Affiliated Hospital of Southern Medical University, from January 2022 to December 2022. All patients had imaging diagnostic supports and were evaluated by attending specialists. According to the standard use of argatroban during the treatment period, the patients were divided into argatroban group (experimental group) and non-argatroban group (control group). Patients in the control group were treated according to the conventional acute ischemic stroke diagnosis and treatment plan, that is, patients who meet the requirements of intravenous thrombolysis and mechanical thrombectomy were treated in the acute phase within the time window, while patients who seek treatment outside the time window were treated with antiplatelet therapy, improved circulation, monitoring blood pressure, blood glucose, and other supportive treatments. On the basis of routine treatment, patients in the experimental group were treated with Agatroban Injection. Patients within 48 hours of onset were continuously pumped 5 mL·h^-1 intravenously within 24 hours of admission, followed by 20 mg daily, diluted with 250 mL of 0.9% Sodium Chloride Injection twice, and intravenous drip for seven days.The age, gender, history of hypertension, diabetes, NIHSS score and difference of NIHSS score from admission to discharge was recorded respectively, and the modified Rankin scale (mRS) at admission and discharge was recorded, and all patients were systematically examined and TOAST typed. Any occurrence of thrombocytopenia, hematochezia or intracranial hemorrhage during hospitalization was considered an adverse event. Results The improvement in NIHSS score in experimental group was better than control group (P= 0.022); However, the good discharge rate (proportion of patients with mRS 0—2) was not significantly different between two groups (P= 0.449), and no adverse events occurred in all enrolled cases. Conclusion Argatroban can improve clinical symptoms and has high safety in patients with mild ischemic stroke.

R971