低分子肝素钙联合硫酸氯氢吡格雷治疗进展期脑梗死的效果及对脑血流动力学的影响

Curative effect of low molecular weight heparin calcium combined with clopidogrel hydrogen sulfate on advanced cerebral infarction and their influences on cerebral hemodynamics

目的 分析低分子肝素钙联合硫酸氯氢吡格雷治疗进展期脑梗死的效果及对脑血流动力学的影响.方法 将确山县第一人民医院2017-03-2019-03收治的进展期脑梗死患者按随机数字表法分为观察组与对照组各60例.对照组给予低分子肝素治疗,观察组在对照组基础上联合硫酸氯氢吡格雷.比较2组临床疗效 、脑血流动力学及预后情况,并统计不良反应发生率.结果 观察组总有效率显著高于对照组;治疗后2组脑动脉各分支左右侧平均血流速度(Vm)、BI指数较治疗前均不同程度上升,mRS评分较治疗前不同程度下降,且观察组脑动脉各分支平均Vm、BI指数高于对照组,mRS评分低于对照组,差异均有统计学意义(P<0.05),但不良反应发生率2组差异无统计学意义(χ2=0.258,P=0.611).结论 较单一低分子肝素治疗,联合硫酸氯氢吡格雷治疗进展期脑梗死疗效更佳,可显著改善脑血流动力学,且不增加不良反应风险.

Objective To analyze curative effect of low molecular weight heparin(LMWH)calcium combined with clopidogrel hydrogen sulfate(CHS)on advanced cerebral infarction(ACI)and their influences on cerebral.Methods ACI patients who were admitted to First People's Hospital of Queshan County from March 2017 to March 2019 were divided into observation group and control group by random number table method,60 cases in each group.The control group was treated with LMWH,while observation group was given CHS on basis of control group.The clinical curative effect,cerebral hemodynamics and prognosis were compared between the two groups.The incidence of adverse reactions was statistically analyzed.Results The total response rate of observation group was significantly higher than that of control group.After treatment,mean blood flow velocity(Vm)and BI of all cerebral arteries branches at left and right side in both groups were increased,while mRS score was decreased.The mean Vm and BI of all cerebral arteries branches in observation group were higher than those in control group,while mRS score was lower than that in control group(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(χ2=0.258,P=0.611).Conclusion Compared with single LMWH treatment,curative effect of LMWH combined with CHS is better on ACI,whose improvement on cerebral hemodynamics is more significant,without increasing risk of adverse reactions.