双联抗血小板治疗短暂性脑缺血发作的疗效分析

Analysis of curative effect by dual anti-platelet in the treatment of transient ischemic attacks

目的分析双联抗血小板(阿司匹林联合氯吡格雷)治疗短暂性脑缺血发作老年患者的临床疗效。方法 80例短暂性脑缺血发作老年患者,随机分为实验组和对照组,各40例。实验组患者第1天予以氯吡格雷治疗,第2天予以阿司匹林、氯吡格雷,7 d后改氯吡格雷长期维持;对照组患者予以阿司匹林至出院继续服用。随访6个月,比较两组患者的治疗效果。结果对照组有4例复发5次,3例复发1次,2例第2天仍有发作,总复发9例(22.5%);4例单肢无力,3例肢体麻木,2例言语含糊,2例偏瘫,脑梗死相关症状总共发生11例(27.5%)。实验组有1例复发4次,1例复发2次,2例复发1次,总复发4例(10.0%);1例(2.5%)发生偏瘫。实验组总复发率及脑梗死相关症状发生率低于对照组(P<0.05)。结论双联抗血小板对于短暂性脑缺血发作的治疗比单用阿司匹林治疗更有效。

Objective To analyze clinical effect by dual anti-platelet（aspirin combined with clopidogrel） in the treatment of senile patients with transient ischemic attacks. Methods A total of 80 senile patients with transient ischemic attacks were randomly divided into experimental group and control group with 40 cases in each group. The experimental group received clopidogrel for first-day treatment, and aspirin combined with clopidogrel at the second day, followed by long-term clopidogrel after 7 d. The control group received aspirin by continuous administration after discharge. Follow-up lasted for 6 months, and curative effects were compared between the two groups. Results There were totally 9 recurrent cases（22.5%） in the control group, as 4 cases for 5 times, 3 cases for 1 time and 2 cases with continuous attack. There were 11 cases（27.5%） with cerebral infarction-related symptoms, as 4 cases with single limb weakness, 3 cases with extremities numbness, 2 cases with vague language, and 2 cases with hemiplegia. The experimental group had totally 4 recurrent cases（10.0%）, as 1 case for 4 times, 1 case for 2 times, and 2 cases for 1 time. There was 1 case（2.5%） with hemiplegia. The experimental group had obviously lower total recurrence rate and incidence of cerebral infarction-related symptoms than the control group（P〈0.05）. Conclusion Dual anti-platelet is more effective than single use of aspirin in treating transient ischemic attacks.