阿司匹林联合氯吡格雷治疗急性脑梗死41例临床观察

Clinical observation of Aspirin and clopidogrel treated acute cerebral infarction

目的比较阿司匹林与氯吡格雷联合使用治疗急性脑梗死的有效性和安全性。方法选择急性脑梗死82例患者,随机分为联合治疗组41例和对照组41例,联合治疗组给予拜阿司匹林与氯吡格雷联合治疗1周,后改单服拜阿司匹林治疗;对照组单服拜阿司匹林治疗。疗程4周观察治疗前后血浆高敏C反应蛋白及血小板聚集率变化,并进行疗效、安全及卒中进展率复发率的对比分析。结果脑梗死进展率复发率联合治疗组明显低于对照组;治疗后联合治疗组NIHSS与Barthel指数评分分别为(3±2.86)、(60±13.76),对照组NIHSS与Barthel指数评分分别为(6±2.38)、(75±11.13),两组比较差异有统计学意义(P<0.01)。联合治疗组与对照组对高敏C反应蛋白及血小板聚集率有明显抑制(P<0.01),但联合治疗组明显低于对照组(P<0.01)。结论拜阿司匹林联合氯吡格雷治疗急性脑梗死疗效优于单用拜阿司匹林,安全性高,值得临床推广。

Objective Comparison of aspirin and clopidogrel efficacy and safety of the treatment of acute cerebral infarction.Methods 82 cases of acute cerebral infarction were randomly divided into 41 cases of the combined treatment group and control group（n=41）.The combination therapy group gave aspirin and clopidogrel combination therapy a week,changed a single aspirin treatment;The control group was aspirin therapy.Comparative efficacy analysis after four weeks.Observed Plasma high-sensitivity C-reactive protein（hs-CRP）,and platelet aggregation rate before and after treatment,and the comparative analysis of the efficacy,safety and rate of progression of stroke recurrence rate.Results The recurrence rate of cerebral infarction rate of progression of the combination therapy group was significantly lower than the aspirin treatment group;After treatment,the combination therapy group（NIHSS and Barthel Index scores were 3±2.86,60±13.76） and the aspirin treatment group（NIHSS and Barthel Index scores were6±2.38,75±11.13） there were significant difference（P0.01）.The combination therapy group and the aspirin treatment group for hs-CRP and platelet aggregation rate was inhibited but the combined treatment group was significantly lower than the control group（P0.01）.Conclusions Aspirin plus clopidogrel in the treatment of acute cerebral infarction is better than aspirin alone,safe and worthy of promotion..