奥扎格雷联合阿司匹林双抗血小板治疗糖尿病并急性脑梗死临床观察

Clinical observation on ozagrel aspirin dual antiplatelet therapy of diabetes and acute cerebral infarction

目的观察奥扎格雷联合阿司匹林抗血小板治疗糖尿病并急性脑梗死临床疗效及安全性。方法将符合入选标准的142例患者随机分为治疗组64例和对照组78例。2组病人均予胰岛素或口服降糖药积极控制血糖,采用相同的基础治疗和对症处理,治疗组给予奥扎格雷联合阿司匹林,对照组单用阿司匹林抗血小板治疗。分别在治疗前及治疗第14天监测血小板参数并进行神经功能缺损评分(NIHSS),并记录出血不良反应。结果治疗后2组患者反映血小板功能增强的MPV、PWT和P-LCR三项指标均明显降低,治疗前后差异有统计学意义(P<0.05),治疗组降低更加明显,差异有统计学意义(P<0.05);治疗后治疗组NlHSS评分较对照组减少明显,显效率明显高于对照组,差异有统计学意义(P<0.05)。2组均无脑出血等严重出血事件发生。结论糖尿病并急性脑梗死患者急性期短期应用奥扎格雷联合阿司匹林抗血小板治疗,可明显提高临床疗效,明显优于单用阿司匹林,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical effect and safety of ozagrel combined with aspirin or aspirin antiplatelet ther-apy of diabetes and acute cerebral infarction. Methods Totylly 142 patients were randomly divided into treatment group （64 cases） and control group（78 cases）.All patients were treated with insulin or oral medications to positively control blood sugar.On the common basis of treatment ,treatment group were given Ozagrel and aspirin ,the control group use aspirin antiplatelet therapy. before and after treatment for 14 d platelet parameters and neural function defect score （NIHSS） scores ,bleeding and record adverse reactions were monitored Respectively. Results After treatment in Two groups ,MPV ,PWT and P-LCR which reflect platelet function were significantly lower （P〈0.05） ,compared with those before treatment ,the treatment group reduced more significantly ,the difference between the two groups was statistically significant （P〈0.05）;after treatment ,NlHSS score of the treatment group reduced more obviously than that of the control group ,the efficiency of the treatment group was signifi-cantly higher than that of the control group ,the difference was statistically significant （P〈0.05）. Two groups had no serious bleeding events such as brain hemorrhage.Conclusion Ozagrel combined with aspirin antiplatelet therapy for the diabetic pa-tients with acute cerebral infarction in acute stage for short term ,can obviously improve the clinical curative effect ,is superior to aspirin alone ,has no obvious side effects ,and is worthy of clinical popularization and application.