目的 比较常规使用肝素和阿加曲班治疗下肢深静脉血栓（DVT）患者的临床疗效。方法 将188例下肢DVT患者按照随机数字表分成阿加曲班组（n=94）和对照组（低分子肝素钙+尿激酶，n=94），比较2组患者治疗前、后双侧肢体周径差和疗效的差异，并在治疗过程中监测凝血指标（PT、APTT及PLT）变化。结果 阿加曲班组治疗10 d后，双侧肢体周径差较治疗前明显减小（Plt;0.05），总有效率（97.87%）优于对照组（89.37%），Plt;0.05。阿加曲班组无血小板减少症（HIT）发生，对照组发生2例HIT； 阿加曲班组PT、APTT和PLT变化均处于正常范围，与对照组比较差异无统计学意义（Pgt;0.05）。结论 阿加曲班治疗下肢DVT安全、有效。
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.