Effect of argatroban on neurological function, vascular endothelial function and coagulation function in patients with atrial fibrillation and cerebral embolism

Zhuang Lili; Che Hao; Hui Xinchen

doi:10.3760/j.issn.1673-4777.2019.12.004

Abstract：Objective To explore the effect of argatroban on neurological function,vascular endothelial function and coagulation function in patients with atrial fibrillation and cerebral embolism.Methods Ninety patients with atrial fibrillation and cerebral embolism admitted to Xuzhou Central Hospital,Jiangsu Province from January 2016 to February 2019 were randomly divided into observation group and control group,with 45 cases in each group.The control group was treated with 0.9％ sodium chloride injection and dabigatran etexilate capsules.The observation group had intravenous administration of argatroban and took dabigatran etexilate capsules.Neurological function,vascular endothelial function,coagulation function and the overall efficacy were analyzed.Results At 8 and 30 days after treatment,score of National Institute of Health Stroke Scale (NIHSS),levels of serum endothelin-1 (ET-1) and homocysteine (Hcy) significantly decreased in both groups;NIHSS score,ET-1 and Hcy levels in observation group were lower than those in control group[8 d:(9.2 ± 1.3) vs (15.1 ±3.2),(70 ±6)ng/L vs (76 ±7)ng/L,(13 ±3)μmol/L vs (18 ±4) μmol/L;30 d:(8.5 ± 1.0) vs (14.4 ±3.5),(72 ±7) ng/L vs (78 ±8) ng/L,(13 ±3) μmol/L vs (19 ±4) μmol/L] (all P ＜0.05);Barthel score and serum nitric oxide level significantly increased in both groups and they were higher in observation group than those in control group[8 d:(77 ±8) vs (60 ±6),(62 ±6) μ mol/L vs (55 ±5) μmol/L;30 d:(81 ±8) vs (63 ±6),(58 ±6) μ mol/L vs (52 ±5) μμmol/L] (all P＜0.05).At 8 days after treatment,thrombin time(T]),activated partial thromboplastin time(APTT) and prothrombin time(PT) significantly increased in both groups;the indexes in observation group were higher than those in control group [(45.0 ± 7.8) s vs (16.6 ± 3.2) s,(45 ± 8) s vs (32 ± 6) s,(21.7 ± 4.1) s vs (14.3 ± 3.8) s] (all P ＜ 0.05).TT,APTT and PT at 30 days after treatment in observation group were higher than those before treatment and those in control group (all P ＜ 0.05).The total effective rate in observation group was significantly higher than that in control group [88.9％ (40/45) vs 71.1％ (32/45)] (P =0.035).Conclusions Argatroban has good anticoagulant effect and can improve neurological and vascular endothelial function.It is an effective method to treat atrial fibrillation complicated with cerebral embolism.