轻度急性脑梗死患者双抗维持治疗3周的作用及安全性探讨

Discussion on effect and safety of dual anti-maintenance therapy for 3 weeks in patients with mild acute cerebral infarction

目的探讨轻度急性脑梗死患者双抗维持治疗3周的作用及安全性。方法 92例接受双抗维持治疗的轻度急性脑梗死患者,随机分为单一组(基础治疗+阿司匹林)与联合组(基础治疗+阿司匹林+氯吡格雷),各46例。比较两组患者治疗前后神经功能缺损情况、血液流变学指标以及临床疗效、不良反应发生情况。结果治疗前,两组患者美国国立卫生院卒中量表评分(NIHSS)、全血低切粘度、血浆粘度、纤维蛋白原比较,差异无统计学意义(P>0.05);治疗后,两组患者NIHSS评分、全血低切粘度、血浆粘度、纤维蛋白原均低于治疗前,且联合组患者上述指标均低于单一组,差异具有统计学意义(P<0.05)。联合组患者治疗总有效率为91.30%,明显高于单一组的76.09%,差异具有统计学意义(P<0.05)。单一组患者不良反应发生率为2.17%,联合组患者不良反应发生率为4.35%,比较差异无统计学意义(χ~2=0.345, P=0.557>0.05)。结论轻度急性脑梗死患者双抗维持治疗中应用氯吡格雷与阿司匹林治疗3周可改善患者神经功能缺损情况、血液流变学指标,临床疗效显著,不会明显增加不良反应。

Objective To discuss the effect and safety of dual anti-maintenance therapy for 3 weeks in patients with mild acute cerebral infarction.Methods A total of 92 patients with mild acute cerebral infarction receiving dual anti-maintenance therapy were randomly divided into single group(basic therapy+aspirin)and combined group(basic therapy+aspirin+clopidogrel),with 46 cases in each group.Comparison were made on neurological deficits,hemorheological parameters,clinical efficacy and adverse reactions before and after treatment between the two groups.Results Before treatment,there was no statistically significant difference in National Institutes of Health Stroke Scale(NIHSS),whole blood low-cut viscosity,plasma viscosity and fibrinogen(P>0.05).After treatment,both groups had lower NIHSS score,whole blood low-cut viscosity,plasma viscosity and fibrinogen than those before treatment,and the combined group was lower than the simple group.Their whole blood low-cut viscosity,plasma viscosity and fibrinogen(P<0.05).Combined group had obviously higher total treatment effective rate as 91.30%than 76.09%in single group,and the difference was statistically significant(P<0.05).Single group had incidence of adverse reactions as 2.17%,which was 4.35%in the combined group,and their difference was statistically significant(χ2=0.345,P=0.557>0.05).Conclusion Dual anti-maintenance therapy of clopidogrel and aspirin for 3 weeks shows remarkable clinical efficacy in mild acute cerebral infarction patients,and it can improve the neurological deficits and hemorheological indexes with no significant adverse effects.