Oguro Hiroaki, Mitaki Shingo, Takayoshi Hiroyuki, Abe Satoshi, Onoda Keiichi, Yamaguchi Shuhei
Department of Neurology, Shimane University Hospital, Izumo City, Shimane, Japan.
Department of Neurology, Shimane University Hospital, Izumo City, Shimane, Japan.
J Stroke Cerebrovasc Dis. 2018 Aug;27(8):2175-2181. doi: 10.1016/j.jstrokecerebrovasdis.2018.03.016. Epub 2018 Apr 26.
Argatroban is a thrombin inhibitor agent for acute noncardioembolic ischemic stroke in Japan. We studied the prognosis in patients with acute stroke treated by argatroban in comparison with the control group with ozagrel in our hospital.
A total of 513 patients with acute noncardioembolic ischemic stroke were enrolled retrospectively from our hospital database. Of all patients with stroke, 353 were administered with argatroban. The other 160 control patients were administered with ozagrel. The patients were examined as to their stroke types, the neurological severity according to the National Institutes of Health Stroke Scale (NIHSS), and clinical outcomes on discharge were determined according to the modified Rankin Scale (mRS).
A total of 353 patients with acute noncardioembolic stroke, including 138 with lacunar infarction (LIs) and 215 with atherothrombotic infarction (ATI) showed functional recovery by argatroban, but the effectiveness of argatroban was not superior to ozagrel therapy defined by the control group. A total of 255 patients with ATI who were treated with both argatroban and ozagrel showed improvement by 1 point. We could not find any significant difference between argatroban and ozagrel in the 2 stroke subtypes, LI and ATI. We also found that combination therapy of argatroban and edaravone was not superior to argatroban monotherapy in clinical outcome.
Argatroban therapy was not superior to control with ozagrel therapy in acute noncardioembolic ischemic stroke, including LI and ATI, regardless of the use of edaravone.
在日本，阿加曲班是一种用于治疗急性非心源性栓塞性缺血性卒中的凝血酶抑制剂。我们在我院研究了接受阿加曲班治疗的急性卒中患者与接受奥扎格雷治疗的对照组患者的预后情况。
从我院数据库中回顾性纳入了513例急性非心源性栓塞性缺血性卒中患者。在所有卒中患者中，353例接受了阿加曲班治疗。另外160例对照患者接受了奥扎格雷治疗。对患者的卒中类型、根据美国国立卫生研究院卒中量表（NIHSS）评估的神经功能严重程度进行了检查，并根据改良Rankin量表（mRS）确定出院时的临床结局。
共有353例急性非心源性卒中患者，包括138例腔隙性梗死（LI）患者和215例动脉粥样硬化血栓形成性梗死（ATI）患者，接受阿加曲班治疗后功能得到恢复，但阿加曲班的疗效并不优于对照组的奥扎格雷治疗。共有255例接受阿加曲班和奥扎格雷联合治疗的ATI患者病情改善了1分。在LI和ATI这两种卒中亚型中，我们未发现阿加曲班和奥扎格雷之间存在任何显著差异。我们还发现，阿加曲班与依达拉奉联合治疗在临床结局方面并不优于阿加曲班单药治疗。
在急性非心源性缺血性卒中（包括LI和ATI）中，无论是否使用依达拉奉，阿加曲班治疗并不优于奥扎格雷对照治疗。
