不同剂量氯吡格雷和阿司匹林在急性脑梗死防治中的作用对比

Comparative analysis on clopidogrel at different doses and aspirin in the treatment of acute cerebral infarction

目的比较不同剂量氯吡格雷与阿司匹林在治疗和预防脑梗死中的临床疗效。方法选取2013-01—2015-01我院收治的急性脑梗死患者80例,随机分为氯吡格雷100mg组、氯吡格雷50mg组与阿司匹林组。治疗后对3组临床疗效进行比较,并对3组治疗前后神经功能缺损(NIHSS)评分情况及不良反应发生情况进行观察。结果与阿司匹林组比较,氯吡格雷100mg组与氯吡格雷50mg组临床总有效率均显著提高(P<0.05);其中氯吡格雷100mg组显效率较氯吡格雷50mg组显著提高(P<0.05);与治疗前比较,3组治疗后NIHSS评分均明显下降,差异均具有统计学意义(P<0.05);其中NIHSS评分降低最为显著的是氯吡格雷100mg组,与其他2组比较,差异均有统计学意义(P<0.05);3组不良反应发生率比较均无显著性差异(P>0.05)。结论氯吡格雷在急性脑梗死治疗和预防中的临床疗效优于阿司匹林,能显著降低神经功能缺损评分,且氯吡格雷100mg临床疗效优于氯吡格雷50mg。

Objective To compare clinical effects of clopidogrel at different doses and aspirin in the treatment of acute cerebral infarction.Methods We recruited eighty cases with acute cerebral infarction in our hospital from January 2013 to January 2015 and randomly divided them into three groups,namely clopidogrel（100 mg）group,clopidogrel（50 mg）plus aspirin group and aspirin group.Clinical curative effects,neurological functional deficit scores（NIHSS）and adverse events between two groups were observed and compared.Results Compared with aspirin group,clopidogrel group and clopidogrel plus aspirin group showed higher total effective rate（P〈0.05）,and clopidogrel group got better clinical curative rate relative to clopidogrel plus aspirin group（P〈0.05）.After treatment,NIHSS scores in all three groups were obviously decreased（P〈0.05）,and the clopidogrel group presented the most tremendous decreases and showed statistical differences compared with the other two groups（P〈0.05）.No significant differences were found between three groups in terms of adverse events（P〈0.05）.Conclusion Clopidogrel which can effectively decrease NIHSS scores may have better clinical efficacy than aspirin in treating acute cerebral infarction,and 100 mg of clopidogrel is superior to 50 mg of clopidogrel.