阿司匹林联合氯吡格雷抗血小板治疗后循环脑梗死的效果观察

Clinical efficacy of antiplatelet therapy with aspirin and clopidogrel for posterior circulation cerebral infarction

目的观察阿司匹林联合氯吡格雷治疗后循环脑梗死的疗效。方法 306例后循环脑梗死患者随机分为对照组和研究组,分别采用阿司匹林或氯吡格雷联合阿司匹林治疗3周。比较两组凝血指标、血脂、疗效、治疗后30 d改良Rankin量表(m RS)及Barthel指数的变化。结果与对照组比较,研究组凝血酶原时间、活化部分凝血酶原时间、高密度脂蛋白胆固醇水平增加,而纤维蛋白原、三酰甘油、总胆固醇和低密度脂蛋白胆固醇水平降低(P<0.01)。研究组的疗效、m RS评分和Barthel评分均优于对照组(P<0.01或0.05)。结论阿司匹林联合氯吡格雷抗血小板治疗后循环脑梗死可有效改善血凝状态,疗效确切。

Objective To observe the clinical efficacy of antiplatelet therapy with aspirin and clopidogrel for posterior circulation cerebral infarction （PCCI）. Methods A total of 306 PCCI patients were randomized to control and observation groups, and treated with aspirin or clopidogrel plus aspirin for 3 weeks. Coagulation indexes, serum lipids, clinical efficacy, and modified Rankin scale （mRS） and barthel index 30 days after therapy were compared between 2 groups. Results Compared with control group, prothrombin time, activated partial prothrombin time, and high density lipoprotein cholesterol content were increased, while levels of fibrinogen, triacylglycerol, total cholesterol, low density lipoprotein cholesterol decreased in observation group （P〈0.01）. The clinical efficacy, mRS and barthel index in observation group were superior to those in control group （P〈0.01 or 0.05）. Conclusion Dual antiplatelet therapy with aspirin and clopidogrel is effective for PCCI and can improve the coagulation state.