氯吡格雷联合阿托伐他汀和低分子右旋糖苷治疗分水岭脑梗死的效果及安全性研究

Study of efficacy and safety of Clopidogrel combined with Atorvastatin and Low Molecular Dextran in the treatment of cerebral watershed infarction

目的探讨氯吡格雷联合阿托伐他汀和低分子右旋糖苷治疗分水岭脑梗死的效果及安全性情况。方法分析我院2016年10月~2017年1月神经内科收治的65例分水岭脑梗死患者的临床资料,依据治疗方式不同分为对照组(低分子右旋糖酐治疗组)(25例)和观察组(氯吡格雷联合阿托伐他汀治疗组)(40例)。对照组给予低分子右旋糖酐治疗,观察组给予氯吡格雷联合阿托伐他汀治疗。比较两组患者治疗前后的ADL评分、NIHSS评分和BI评分,观察两组患者的临床治疗总有效率及分水岭脑梗死7 d神经功能恶化、症状性颅内出血、死亡发生率。结果两组分水岭脑梗死患者治疗前的ADL评分、NIHSS评分和BI评分比较,差异无统计学意义(P>0.05)。两组治疗后的ADL评分、NIHSS评分和BI评分均高于治疗前,观察组患者治疗后的ADL评分、NIHSS评分和BI评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者的临床治疗总有效率高于对照组,分水岭脑梗死7 d神经功能恶化、症状性颅内出血、死亡发生率均低于对照组,差异有统计学意义(P<0.05)。结论氯吡格雷联合阿托伐他汀治疗分水岭脑梗死患者的临床效果明显,临床症状改善良好,不良事件发生率低,值得临床推广应用。

Objective To investigate the efficacy and safety of Clopidogrel combined with Atorvastatin and Low Molec- ular Dextran in the treatment of cerebral watershed infarction.Methods From October 2016 to January 2017,the clinical data of 65 patients with cerebral watershed infarction in our department were analyzed.According to different therapeu- tic methods,they were divided into the control group （n=25） and the observation group （n=40）.The control group was treated with low molecular dextran,and the observation groupwas treated with Clopidogrel combined with Atorvastatin. The activities of daily living （ADL） score,NIHSS score,and BI score before and after treatment were compared between the two groups.The total effectiveness rate of clinical treatment,the incidence rate of deterioration of neurological func- tion in the 7 days of cerebral watershed infarction,symptomatic intracranial hemorrhage,and death were obserced in the two groups.Results There was no significant difference in the ADL score,NIHSS score,and BI score before treatment in the two groups （P〉0.O5）.The ADL score,NIHSS score,and BI score after treatment in the two groups were all higher than those before treatment,and the ADL score,NIHSS score,and BI score after treatment in the observation group were all superior to those in the control group,with significant difference （P〈0.05）.The total effectiveness rate in the observation group was higher than that in the control group,the incidence rate of neurological deterioration in the 7 days of cerebral watershed infarction,symptomatic intracranial hemorrhage,and death in the observation group were lower than those in the control group,with statistical differences （P〈0.05）.Conchtsion Application of Clopidogrel combined with Atorvastatin in the treatment of cerebral watershed infarction has a remarkable clinical effect,great improvement of clinical symp- toms,and low incidence of adverse events,which is worthy of clinical promotion and application.