ObjectiveTo systematically review the effectiveness and safety of argatroban for patients with acute ischemic stroke. MethodsPubMed (1966 to 2013.12), EMbase (1966 to 2013.12), CENTRAL (2013.12), CBM (1978 to 2013.12), VIP (1989 to 2013.12), CNKI (1980 to 2013.12) and CDFD (for masters and Phds, 1999 to 2013.12) were electronically searched for randomized controlled trials (RCTs) on argatroban for patients with acute ischemic stroke. Meanwhile, relevant data were retrieved by hand search and the data from pharmaceutical factories (TIPR Pharmaceutical Responsible Co. Ltd) were collected. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 11 RCTs involving 889 patients were finally included. The results of meta-analysis showed that the argatroban group was better than the control group in improving patients' neurologic impairment scores (SMD=0.71, 95%CI 0.56 to 0.88, P < 0.000 01), and the effectiveness of neurological function (total result:OR=2.65, 95%CI 1.84 to 3.80, P < 0.000 01; placebo-controlled trial:OR=2.18, 95%CI 1.27 to 3.72, P=0.004; non-placebo-controlled trial:OR=3.09, 95%CI 1.89 to 5.06, P < 0.000 01), all with significant differences. No significant difference was found between the argatroban group and the control group in the long/short-term motilities or dependence rates as well as in the incidence of adverse reaction (OR=1.55, 95%CI 0.60 to 4.01, P=0.37). ConclusionCurrent evidence shows that argatroban could improve neurologic impairment of patients with acute ischemic stroke without severe bleeding events or other adverse reaction. However, further studies are needed to confirm its effects on reducing rates of death and disability in treating acute ischemic stroke.
目的 比較常規使用肝素和阿加曲班治療下肢深靜脈血栓（DVT）患者的臨床療效。方法 將188例下肢DVT患者按照隨機數字表分成阿加曲班組（n=94）和對照組（低分子肝素鈣+尿激酶，n=94），比較2組患者治療前、后雙側肢體周徑差和療效的差異，并在治療過程中監測凝血指標（PT、APTT及PLT）變化。結果 阿加曲班組治療10 d后，雙側肢體周徑差較治療前明顯減小（Plt;0.05），總有效率（97.87%）優于對照組（89.37%），Plt;0.05。阿加曲班組無血小板減少癥（HIT）發生，對照組發生2例HIT； 阿加曲班組PT、APTT和PLT變化均處于正常范圍，與對照組比較差異無統計學意義（Pgt;0.05）。結論 阿加曲班治療下肢DVT安全、有效。