不同剂量阿司匹林治疗急性脑梗死疗效对比

Clinical efficacy of different doses of aspirin in treating acute cerebral infarction

目的对比不同剂量阿司匹林治疗急性脑梗死的疗效。方法选择2010年1月—2011年10月140例急性脑梗死患者,随机分为治疗组和对照组,两组均给予对症治疗,治疗组患者入院后即刻给予阿司匹林300 mg研碎顿服,之后300 mg/d空腹顿服;对照组患者入院后即刻给予阿司匹林100 mg研碎顿服,之后100 mg/d空腹顿服。比较两组临床疗效、神经功能缺损评分、C反应蛋白浓度、不良反应。结果治疗第7、14、21、28天总有效率治疗组分别为27.1%、61.4%、87.1%、91.4%,对照组分别为21.4%、41.4%、65.7%、67.1%,两组治疗第14、21、28天总有效率比较差异均有统计学意义(均P<0.05)。治疗前两组神经功能缺损评分、C反应蛋白浓度比较差异无统计学意义(P>0.05),治疗第14、21、28天两组神经功能缺损评分、C反应蛋白浓度比较差异均有统计学意义(均P<0.05)。治疗第21天与第28天两组组内总有效率、神经功能缺损评分、C反应蛋白浓度比较差异均无统计学意义(均P>0.05)。治疗组发生胃肠道刺激症状和大便隐血阳性占5.7%,均发生于第21天后;对照组发生胃肠道刺激症状和大便隐血阳性占4.2%,1例发生于第21天前,2例发生于第21天后;两组比较差异无统计学意义(P>0.05)。结论治疗急性脑梗死患者应用阿司匹林300 mg/d比100 mg/d疗效更好,疗程为21 d更合适,既保证疗效,又不增加不良反应。

Objective To compare the clinical efficacy of different doses of aspirin in treating acute cerebral infarction.Methods 140 cases of acute cerebral infarction were randomly divided into treatment group and control group,both were given symptomatic treatment from January 2010 to October 2011.Aspirin,300 mg（ground into powder）,was administered to the treatment group immediately on admission,and 300 mg/d on an empty stomach subsequently;while aspirin,100 mg（ground into powder） to the control group and 100 mg/d subsequently.Clinical efficacy,nerve defect scoring（NDS）,c-reactive protein levels and adverse reactions were compared in both groups.Results In the treatment group,the total effective rate was 27.1%,61.4%,87.1%% and 91.4% on day 7,14,21,28 after treatment respectively;while in the control group,it was 21.4%,41.4%,65.7% and 67.1% respectively.There were significant statistical differences in total effective rate on day 14,21,28 between the two groups（P0.05）.There was no statistical difference of NDS in both groups before treatment（P0.05）.Statistical differences of NDS in both groups were found on day7,14,21 after treatment（P0.05）.There was no statistical difference of C-reactive protein levels in both groups before treatment（P0.05）.Statistical differences of C-reactive protein levels in both groups were found on day7,14,21 after treatment（P0.05）.In the treatment group,5% of the cases were found to have gastrointestinal symptoms and positive occult blood,all occurred 21 days after treatment.In the control group,gastrointestinal symptoms and positive occult blood were found in only 4.2% of the cases,of which,1 case occurred during the first 21 days after treatment,2 cases in day 21 or later.No significantly statistical differences were found between the two groups（P 0.05）.Conclusion Acute cerebral infarction treated with aspirin（300mg/d）has a better efficacy than with aspirin（100 mg/d）.A 21-day treatment course is more appropriate without increasing adverse reactions.