三七三醇皂苷与阿司匹林联合应用在脑梗死二级预防中的临床价值

Clinical Value of Protoparaxotril Saporlirs Combined with Aspirin in the Secondary Prevention of Cerebral Infarction

目的观察三七三醇皂苷(PTS)与阿司匹林联合应用在脑梗死二级预防中的临床价值。方法收集140例脑梗死恢复期患者,其中120例按随机单盲开放对照原则分为PTS组、阿司匹林组、PTS联合阿司匹林组各40例,20例不能或不愿使用阿司匹林的患者为对照组,均治疗6个月,期间记录血小板聚集率、卒中再发生率、消化道不良反应和美国国立卫生研究院卒中量表(NIHSS)评分。结果3个治疗组血小板聚集率的下降幅度均较对照组明显(P<0.01);治疗3个月时PTS组患者5 min血小板聚集率的下降幅度小于阿司匹林组(P<0.05),治疗6个月时两组差异无统计学意义(P>0.05)。PTS组、阿司匹林组、PTS联合阿司匹林组脑卒中再发率分别为18.9%、13.2%、10.8%,较对照组(44.4%)明显下降(P<0.05).3个治疗组之间差异无统计学意义。PTS组和PTS联合阿司匹林组NIHSS评分较阿司匹林组明显下降(P<0.01)。PTS组消化道不良反应较其他3组明显减少(P<0.01)。结论长期应用三七三醇皂苷具有预防脑卒中再发、减少消化道不良反应和改善卒中后神经功能的作用。PTS联合阿司匹林应用在脑卒中的二级预防中可能有重要的临床应用价值。

Objective To observe the clinical value of protoparaxotril saporlirs （PTS） combined with aspirin in the secondary prevention of cerebral infarction. Methods The 140 patients with cerebral infarction were collected, among them the 120 patients during recovery stage were equally assigned to three groups by randomized, single blinded and open controlled principle, and they were treated respectively by PTS （A） , aspirin （B） , and PTS plus aspirin （C） for 6 months. The other 20, who couldn＇t or were unwilling to use aspirin, were arranged in group D for control. The platelet aggregation rate, incidence of stroke recurrence, gastrointestinal adverse reaction and the NIHSS scores of patients were observed during the six-month period of treatment. Results As compared with group D, the lowering amplitude of platelet aggregation rate after treatment in the three treatment groups were significantly higher （P 〈0.01 ）. Comparison of platelet aggregation rate between group A and B showed significant difference after 3-month treatment （ P 〈0.05 ） , but the difference became insignificant after 6-month treatment （ P 〉 0.05 ）. The incidence of stroke recurrence in the group A, B and C was 18.9% , 13.2% and 10.8% respectively, which showed no significant difference among them, but all were significantly lower than that in the group D （44.4% , P 〈0.05）. NIHSS scores in group A and C were significantly lower than in group B （P 〈0.01 ） ; and the occurrence of gastrointestinal reaction was significantly lower in group A （P 〈0.01 ）. Conclusion Long-term application of PTS has the effects for preventing stroke recurrence, lowering gastrointestinal adverse reaction and improving patients＇ neural function in patients with stroke. As used in combination with aspirin, it shows potential practical importance in the clinical secondary prevention of stroke.