阿司匹林联合氯吡格雷治疗进展性脑卒中的疗效评价

Evaluation on Clinical Efficacy of Aspirin Combined with Clopidogrel in Treatment of Progressive Cerebral Stroke

目的评估阿司匹林联合氯吡格雷治疗进展性脑卒中的临床价值。方法选取进展性脑卒中患者73例,随机分为治疗组37例和对照组36例。对照组给予阿司匹林治疗,治疗组联合应用阿司匹林和氯吡格雷,观察两组临床疗效,治疗前后神经功能缺损程度、日常生活能力(ADL)、超敏C反应蛋白(hs-CRP)水平的变化及不良反应发生情况。结果治疗组总有效率为91.89%,明显高于对照组的72.22%(P<0.05)。治疗后7 d、14 d,两组美国国立卫生研究院卒中量表(NIHSS)评分较治疗前明显降低,ADL评分明显升高(P<0.05或P<0.01),但治疗后14 d治疗组降低及升高幅度更大(P<0.05)。与治疗前比较,两组治疗后7 d hs-CRP水平明显升高,治疗后14 d明显降低(P<0.01),但治疗后14 d治疗组降低程度更为显著(P<0.05)。治疗期间,两组均未见明显不良反应发生。结论早期应用阿司匹林联合氯吡格雷能有效缓解进展性脑卒中患者的临床症状,提高ADL,降低hs-CRP水平,且疗效显著。

OBJECTIVE To evaluate the clinical value of aspirin combined with clopidogrel in treatment of progressive cerebral stroke.METHODS A total of 73 patients with progressive cerebral stroke was selected and randomly divided into treatment group（n=37） and control group（n=36）. Control group was treated with aspirin, while treatment group with aspirin combined with clopidogrel. The clinical efficacy, the changes of neurological deficit score, activities of daily living（ADL） and high-sensitivity C-reactive protein（hs-CRP）level before and after treatment, and the occurrence rates of adverse reactions were observed in both groups. RESULTS The total response rate（RR） was 91.89% in treatment group, which was evidently higher than the 72.22% in control group（P〈0.05）. National Institutes of Health Stroke Scale（NIHSS） score was decreased evidently while ADL score was increased notably on post-treatment d7 and 14（P〈0.05 or P〈0.01）, but the decrease and increase amplitudes were more significant in treatment group than those in control group on postoperative d14（P〈0.05）. Compared with treatment before, hs-CRP level was increased markedly on postoperative d7 and was decreased notably on postoperative d14 in both groups（P〈0.01）, but the decrease amplitude on postoperative d14 was more significant in treatment group than control group on postoperative d14（P〈0.05）. During treatment, no significant adverse reactions were found in either group. CONCLUSION Early application of aspirin combined with Clopidogrel could effectively relieve the clinical symptoms, increase ADL, and reduce hs-CRP level with significant clinical efficacy in the treatment of patients with progressive cerebral stroke.