氯吡格雷联合阿司匹林治疗急性脑梗死合并脑微出血患者的安全性和疗效分析

Safety analysis of clopidogrel combined with aspirin therapy for acute cerebral infarction combined micro cerebral hemorrhage patients

目的 旨在分析氯吡格雷联合阿司匹林治疗急性脑梗死合并脑微出血患者的安全性及疗效。方法 选取2015年5月~2016年5月于天津市职业病防治院进行诊治的76例急性脑梗死合并脑微出血患者进行研究,随机将其分为观察组和和对照组,观察组在常规治疗的同时给予阿司匹林和氯吡格雷口服,对照组在常规治疗的同时仅给予阿司匹林口服。观察神经功能缺损国立卫生研究院卒中量表评分（national instituteof health stroke scale,NIHSS）和日常生活活动能力巴氏指数,测定患者血浆粘度、全血低切粘度,AA诱导和ADP诱导的血小板最大聚集率（MARAA、MARADP）,观察记录治疗期间患者出现的不良反应,进行统计分析。结果 与治疗前相比,观察组与对照组接受治疗2周后,NIHSS评分、巴氏评分和相关血液指标均显著改善,差异具有统计学意义（P〈0.05）。与对照组相比,治疗后观察组NIHSS评分、巴氏评分和相关血液指标均显著改善,总有效率显著提高,差异均具有统计学意义（P〈0.05）。2组不良反应发生情况比较差异无统计学意义。结论 氯吡格雷联合阿司匹林能够有效治疗急性脑梗死合并脑微出血患者,且具有安全性。

Objective To analyze clopidogrel combined with aspirin therapy of acute cerebral infarction the safety and efficacy of micro brain hemorrhage patients. Methods Se l e c t from May 2015 and May 2015 months in the hospital for d i a g nosis and treatment of 76 cases o f acute cere b r a l infarction combined micro cerebral hemorrhage patient study, observation group in the conventional treatment at the same time giving oral aspirin and clopidogrel, the control group in the conventional treatment at the same time, only to give oral aspirin. To observe the nerve function defect National institutes of Health stroke scale score （ National Institute of Health stroke scale, NIHSS） and daily life activities ability pap index, determination of patients^blood plasma viscosity, whole blood low shear viscosity, AA induction and the platelet maximum aggregation rate induced by ADP （ MAR a a , MARAdp）, observation records during the treatment patients with adverse reactions, were analyzed. Results C o m p a r e d w i t h b e f o r e t r e a t m e n t , the observation group and control group after treatment for 2 weeks, NIHSS score, score and blood related indexes were significantly improved, statistically significant difference （P 〈 0. 05）. Compared with control group, the observation group after treatment the NIHSS score, pap score and blood related indexes were significantly improved, total effective rate increased significantly, the differences were statistically significant （P 〈 0. 0 5 ）. T w o g r o u p s of adverse drug reactions occurred situation is no statistical difference. Conclusion C l o p i d o g r e l in c o m b i n a t i o n w i t h aspirin c a n effective t r e a t m e n t in patients with acute cerebral infarction combined micro brain hemorrhage, and security.