阿司匹林联合氯吡格雷治疗糖尿病合并急性脑梗死疗效分析

Effect of clopidogrel plus aspirin in the treatment of acute ischemic stroke with diabetes mellitus

目的：观察阿司匹林联合氯吡格雷治疗糖尿病合并急性脑梗死的临床疗效。方法选择糖尿病合并急性脑梗死患者64例，采用数字表法随机分为联合治疗组（32例）、对照组（32例），联合治疗组在常规治疗基础上给予阿司匹林和氯吡格雷治疗，对照组在常规治疗基础上单用阿司匹林治疗，分别在治疗前及治疗后14 d 予以神经功能缺损（NIHSS）评分，使用 Barthel 指数对两组患者的日常生活能力进行评定，观察两组临床疗效及其不良反应。结果治疗前联合治疗组、对照组 NIHSS 评分分别为（10．59±4．40）分、（10．63±4.35）分，Barthel 指数分别为（29．40±11．50）、（28．50±12．05）；治疗后联合治疗组、对照组 NIHSS 评分分别为（5．65±1．52）分、（9．16±2．85）分，Barthel 指数分别为（70．60±16．50）、（51．65±11．45），治疗后两组NIHSS 评分均低于治疗前（t ＝11．48，P ＜0．001；t ＝3．10，P ＜0．01），Barthel 指数均较治疗前升高（t ＝44．04， P ＜0．001；t ＝27．01，P ＜0．01），联合治疗组较对照组改善更明显（t ＝12．06，P ＜0．001；t ＝19．12，P ＜0．01），两组均未见颅内出血等严重不良反应。结论阿司匹林联合氯吡格雷双抗血小板治疗糖尿病并急性脑梗死疗效明显优于单用阿司匹林，且安全性较好。

Objective To observe clinical curative effect of of aspirin combined with clopidogrel therapy in the treatment of diabetes complicating acute cerebral infarction.Methods 64 patients with diabetes combined with acute cerebral infarction were selected and randomly divided into combined treatment group（32 cases）and control group（32 cases）,and the joint treatment group on the basis of conventional treatment was given aspirin and clopi-dogrel treatment,the control group on the basis of conventional treatment was given aspirin therapy.14 days before treatment and after treatment,the nerve function defect score（NIHSS）was evaluated,the Barthel index was used to assess daily life ability of patients.The clinical curative effect and adverse reactions of the two groups were observed. Results Before treatment,NIHSS scores in the combined treatment group and control group were （10.59 ±4.40）, （10.63 ±4.35）respectively,Barthel index were （29.40 ±11.50）,（28.50 ±12.05）respectively.After treatment, NIHSS scores in the combined treatment group and control group were （5.65 ±1.52）,（10.63 ±4.35）respectively, Barthel index were （70.60 ±16.50）,（51.65 ±11.45）respectively.NIHSS score was lower than before treatment in the two groups （t =11.48,P 〈0.01,t =3.10,P 〈0.01）,Barthel index was higher than before treatment（t =44.04, P 〈0.01;t =27.01,P 〈0.01）,those of the combination therapy group were improved more significantly than the control group （t =12.06,P 〈0.01;t =19.12,P 〈0.01）.Intracranial hemorrhage and serious adverse reactions were not observed in the two groups.Conclusion The curative effect of aspirin in combination with clopidogrel dual anti-platelet therapy in the treatment of diabetes and acute cerebral infarction was better than aspirin alone,and has better security.