低分子肝素联合阿司匹林治疗急性脑梗塞疗效探讨

Study on Curative Effect of Low Molecular Heparin and Aspirin in Treatment of Acute Cerebral Infarction

目的探讨低分子肝素联合阿司匹林治疗急性脑梗塞临床疗效。方法方便选取2015年2月—2017年2月期间该院神经内科收治的160例患者,采用随机数字表的方法分组,每组80例,对照组患者给予肠溶阿司匹林100 mg口服qd,观察组患者在对照组治疗基础上给予低分子肝素钙,5 000 U/次,腹壁下皮下注射,2次/d,联用7 d,治疗1个月后对两组患者临床效果进行评价。结果治疗前两组患者的神经功能缺损评分分别为(19.89±2.71)分、(20.17±3.01)分,治疗1个月后分别为(11.03±1.89)分、(14.79±2.45)分,两组患者治疗1个月后的神经功能缺损评分显著低于治疗前的评分,差异有统计学意义(t=3.29、4.42,P<0.05);观察组患者治疗后评分显著低于对照组患者,差异有统计学意义(t=3.78,P<0.05)。观察组患者临床总有效率97.50%,显著高于对照组患者82.50%,差异有统计学意义(χ~2=5.85,P<0.05)。观察组患者中出现皮下瘀斑3例,出现肝肾功能损害0例,患者的出凝血时间异常2例,不良反应发生率为6.25%;对照组患者出现皮下瘀斑1例,出现肝肾功能损害1例,患者的出凝血时间异常2例,不良反应发生率为5.00%,两组患者的不良反应发生率比较差异无统计学意义(χ~2=0.34,P>0.05)。结论肠溶阿斯匹林联合低分子肝素钙治疗急性脑梗塞是一种有效、安全的方法,值得在临床上推广应用。

Objective To study the clinical curative effect of low molecular heparin and aspirin in treatment of acute cerebral infarction. Methods 160 cases of patients admitted and treated in our hospital from February 2015 to February 2017 were convenient selected and randomly divided into two groups with 80 cases in each, the control group took 100 mg enteric coated aspirin orally, while the observation group adopted the abdominal subcutaneous injection of low-molecular-weight heparin, 5 000 units once, twice per day for the consecutive 7 days, and the clinical effect of the two groups was evaluated after 1-month treatment. Results The nerve function defect scores of the two groups after 1-month treatment was obviously lower than those before treatment, [(11.03±1.89)points,(14.79±2.45)points vs(19.89±2.71)points,(20.17±3.01)points], and the differences were statistically significant,(t =3.29,4.42,P <0.05), and the score in the observation group was obviously lower than that in the control group with statistical significance(t=3.78,P<0.05), and the total clinical effective rate in the observation group was obviously higher than that in the control group with statistical significance(97.50% vs 82.50%),(χ~2=5.85,P<0.05), and the ecchymosis, function lesion of liver and kidney and abnormal clotting time respectively occurred to 3 cases, 0 case, 2 cases in the observation group and 1 case, 1 case and 2 cases in the control group, and the difference in the incidence rate of adverse reactions between the observation group and the control group was not statistically significant(6.25% vs 5.00%)(χ~2=0.34,P>0.05). Conclusion The enteric coated aspirin combined with low-molecular-weight heparin in treatment of acute cerebral infarction is an effective and safe method, which is worth clinical promotion and application.