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阿司匹林联合氯吡格雷对大脑中动脉狭窄致脑梗死稳定期患者相关指标的影响
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| 篇名： | 阿司匹林联合氯吡格雷对大脑中动脉狭窄致脑梗死稳定期患者相关指标的影响 |
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| 摘要： | 目的：探讨阿司匹林联合氯吡格雷对大脑中动脉狭窄致脑梗死稳定期患者相关指标的影响。方法：回顾性分析127例大脑中动脉狭窄致脑梗死稳定期患者的病历资料，依据治疗药物不同分为观察组（65例）和对照组（62例）。两组患者均给予常规基础治疗，在此基础上对照组患者给予阿司匹林肠溶片200 mg，口服，每天1次；观察组患者在对照组治疗基础上加用硫酸氢氯吡格雷片75 mg，口服，每天1次。两组均连续治疗1年。观察并比较两组患者治疗前后凝血功能相关指标[D-二聚体（D-D）、血小板（PLT）计数、花生四烯酸（AA）诱导的PLT抑制率、二磷酸腺苷（ADP）诱导的PLT抑制率]、日常生活质量评分[改良的Fugl-Meyer评分、Barthel指数、美国国立卫生研究院卒中量表（NIHSS）评分]以及1年累积脑梗死复发情况和不良反应发生情况。结果：治疗前，两组患者上述各项指标比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者D-D水平、NIHSS评分均显著低于同组治疗前，且观察组显著低于对照组；AA诱导的PLT抑制率、ADP诱导的PLT抑制率、改良的Fugl-Meyer评分和Barthel指数均显著高于同组治疗前，且观察组显著高于对照组，差异均有统计学意义（P＜0.05）。观察组患者1年累积脑梗死复发率显著低于对照组，差异有统计学意义（9.23％ vs. 22.58％，P＜0.05）。两组患者治疗期间均未见严重不良反应发生。结论： 与阿司匹林单用相比，阿司匹林联合氯吡格雷用于大脑中动脉狭窄致脑梗死稳定期患者可以显著改善其凝血功能，提高日常生活质量，降低脑梗死复发率，且安全性相当。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of clopidogrel combined with aspirin on related indexes of patients with cerebral infarction induced by middle cerebral artery stenosis in stable phase. METHODS： Clinical data of 127 patients with cerebral infarction induced by middle cerebral artery stenosis in stable phase were analyzed retrospectively and divided into observation group （65 cases） and control group （62 cases） according to therapy drugs. Both groups received routine treatment. Control group was additionally given Aspirin enteric-coated tablet 200 mg orally， once a day. Observation group was additionally given Clopidogrel sulfate tablet 75 mg orally， once a day， on the basis of control group. Both group received treatment for consecutive 1 year. Coagulation function related indexes [D-dimer， PLT， AA-induced platelet inhibition rate， ADP-induced platelet inhibition rate]， daily life quality score [modified Fugl-Meyer scale， Barthel indexes， NIHSS score] before and after treatment， the occurrence of 1-year accumulative cerebral infraction recurrence and ADR were observed and compared between 2 groups. RESULTS： Before treatment， there was no statistical significance in above indexes between 2 groups （P＞0.05）. After treatment， D-dimer level and NIHSS score of 2 groups were significantly lower than before treatment， and the observation group was significantly lower than the control group； AA-induced platelet inhibition rate， ADP-induced platelet inhibition rate， Fugl-Meyer score and Barthel indexes of 2 groups were significantly higher than before treatment， and the observation group was significantly higher the control group， with statistical significance （P＜0.05）. The recurrence rate of 1-year accumulative cerebral infraction in observation group was significantly lower than control group， with statistical significance （9.23％ vs. 22.58％， P＜0.05）. No severe ADR was found in 2 groups during treatment. CONCLUSIONS： Compared with aspirin alone， aspirin combined with clopidogrel in the treatment of cerebral infarction induced by middle cerebral artery stenosis in stage phase can effectively improve coagulation function and quality of daily life， reduce recurrence rate with good safety. |
| 期刊： | 2017年第28卷第30期 |
| 作者： | 李丕武，王海燕，张斌，孙玲 |
| AUTHORS： | LI Piwu，WANG Haiyan，ZHANG Bin，SUN Ling |
| 关键字： | 脑梗死；大脑中动脉狭窄；氯吡格雷；阿司匹林；凝血功能；生活质量；复发率 |
| KEYWORDS： | Cerebral infarction； Middle cerebral artery stenosis； Clopidogrel； Aspirin； Coagulation function； Quality of life； Recurrence |
| 阅读数： | 367 次 |
| 本月下载数： | 7 次 |
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