奥扎格雷注射剂联合长春西汀注射剂治疗脑卒中患者的临床研究

Clinical trial of combination therapy with ozagrel and vinpocetine in the treatment of stroke patients

目的观察奥扎格雷联合长春西汀对脑卒中患者的临床疗效和安全性。方法 120例脑卒中患者随机分为试验组60例和对照组60例,2组患者均予以常规治疗。对照组在常规治疗基础上静脉滴注奥扎格雷钠160 mg qd,试验组在对照组基础上静脉滴注长春西汀30 mg qd,2组患者均连续用药14 d。比较2组患者临床疗效日常生活能力评分(ADL)、美国国立卫生院卒中量表(NIHSS)评分,并检测2组纤维蛋白原、凝血酶原时间、活化部分凝血凝血酶原时间(APTT)、血小板计数、血小板分布宽度、血小板平均体积及药物不良反应发生率。结果治疗后,试验组和对照组的总有效率分别为91.67%(55/60例)和76.7%(46/60例),ADL评分分别为(58.53±9.37),(53.52±8.80)分,NIHSS评分分别为(6.67±2.12),(8.28±2.83)分,血小板分布宽度分别为(17.41±3.60)%,(20.52±3.89)%,血小板平均体积分别为(7.12±0.43)%,(8.17±0.52)%,纤维蛋白原分别为(3.43±0.59),(3.75±0.68)g·L^(-1),差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有紫癜2例和皮疹1例,对照组的药物不良反应有皮疹1例。试验组和对照组的药物不良反应发生率分别为5.00%(3/60例)和1.67%(1/60例),差异无统计学意义(P>0.05)。结论奥扎格雷联合长春西汀能够抑制血小板活化,改善脑卒中患者神经功能,安全性较高。

Objective To evaluate the clinical efficacy and safety of combination therapy with ozagrel and vinpocetine in treatment of stroke.Methods A total of 120 stroke patients were randomly divided into treatment group（ 60 cases） and control group（ 60 cases）. Both groups were given conventional treatment. The control group received intravenous infusion of ozagrel sodium 160 mg qd. The treatment group was given intravenous drip of vinpocetine 30 mg qd. The treatment lasted for 14 days. The clinical efficacy and Activity of Daily Living Scale（ ADL）,National Institutes of Health Stroke Scale（ NIHSS） score of the two groups were compared. The fibrinogen,prothrombin time,activated partial thromboplastin time（ APTT）,platelet count,platelet distribution width,mean platelet volume and adverse drug reactions in 2 groups were compared. Results After treatment,the total effective rates of the treatment group and the control group were 91. 67%（ 55/60 cases） and76. 7%（ 46/60 cases）,the difference was statistically significant（ P〈0. 05）. After treatment,the ADL scores of the treatment group and the control group were（ 58. 53 ± 9. 37）,（ 53. 52 ± 8. 80）,the NIHSS scores were（ 6. 67 ± 2. 12）,（ 8. 28 ± 2. 83）,the PDW were（ 17. 41 ± 3. 60） %,（ 20. 52 ± 3. 89） %,the MPV were（ 7. 12 ± 0. 43） %,（ 8. 17 ± 0. 52） %,the fibrinogen were（ 3. 43 ± 0. 59）,（ 3. 75 ± 0. 68） g·L^（-1）,and the differences between the groups were statistically significant（ P〈0. 05）. The main adverse drug reactions of the treatment group were purpura（ 2 cases） and rash（ 1 case）,while the adverse drug reaction in the control group was rash（ 1 case）. The incidences of adverse drug reactions in the treatment group and the control group were 5. 00%（ 3/60 cases） and 1. 67%（ 1/60cases）,without statistically significant difference（ P〈0. 05）. Conclusion Ozagrel combined with vinpocetine could inhibit platelet activation and improve neural function with high safety in the treatment of stroke.