脑梗死溶栓治疗前应用阿司匹林抗栓处理对促进患者闭塞血管再通的效果研究

Effects of aspirin antithrombotic treatment before thrombolytic therapy in patients with cerebral infarction

目的观察脑梗塞患者溶栓治疗前应用阿司匹林抗栓处理对促进患者闭塞血管再通的作用。方法将2018年1月-2019年7月安徽省太和县人民医院治疗的118例脑梗死患者随机分为两组:对照组(n=69)通过静脉注射尿激酶,然后口服阿托伐他汀观察组(n=49)溶检临时300mg阿司匹林口服,后每天一次口服阿司匹林,持续10d。观察两组患者的预后、认知功能和日常生活能力。结果对照组69例患者中,经治疗好转(血管完全再通)者68例,观察组49例患者中,经治疗好转者48例。两组患者好转率无差别;两组患者治疗前颈动脉血流参数无差别,治疗后,观察组患者颈动脉收缩期峰值血流速度(systolicvelocity,SV)、舒张末期血流速度(dia-stolic velocity,DV)水平高于对照组,阻力指数(resistance index,RI)水平低于对照组(P<0.05);两组患者治疗前认知功能无差别,治疗后,两组患者的定向力、瞬时记忆、注意力计算力得分均较治疗前增高,两组间治疗后认知功能比较无差别;两组患者治疗前日常生活能力无差别,治疗后,两组患者的日常生活能力均高于治疗前,两组间比较差异无统计学意义;对照组69例患者中出现牙龈出出血者4例、脑出血者3例、消化道出血者2例,观察组49例患者中出现牙龈出出血2例、脑出血者2例,两组患者出血性并发症发生率差异无统计学意义。结论脑梗塞患者溶栓治疗前应用阿司匹林抗栓处理对促进患者闭塞血管再通的效果较好,可明显改善患者颈动脉血流參数,且不会增加出血性并发症发生率,具有良好的应用价值。

Objective To observe the effects of aspirin antithrombotic therapy on the recanalization of oceluded vessels before thrombolytic therapy in patients with cerebral infarction.Methods 118 patients with cerebral infarction were randomly divided into 2 demographically and elinically matched groups:control group(n=69)undergoing injection of urokinase through catheter and then oral administration of atorvastatin and intravenous drip of Xueshuantong for 17 days,and observation group(n=49)undergoing oral administration of aspirin once a day for 14 days.The prognosis,cog-nitive function,viability were observed.Results There was no difference in the improvement rate of the lwo groups of patients.There was no significant differences in the parameters of carotid blood flow before treatment.After treatment,the levels of carotid SV and DV of the observation group were both signifcanly higher than those of the control group(both P<0.05),and the RI level of the observation group was significantly lower than that of the control group(P<0.05).There was no significant difference in the cognitive function between these two groups before lreatment.Afier treat-ment,the directional force,instantaneous memory,and attention calculation scores of both groups were all higher than those before treatment.There was no signifcant difference in the cognitive function between these two groups after treatment.There was no significant difference in the daily living ability before treatment.After treatment,the daily liv-ing ability of the two groups was higher than that before treatment.There was no significant difference between the two groups.Four cases of gingival bleeding,2 cases of gastrointestinal beeding,and 3 cases of cerebral bleeding occurred in the control,and 2 ases of gingival beeding,and 2 cases of cerebral hemorrhage occurred in the observation group.However,there was no signifcant f=iference in the complication rate between these 2 groups.Conclusion The appli-cation of aspirin antithrombotic therapy before thrombolytic therapy in patients with cerebral infarction has a beter ef-fect on promoting recanalization,and does not increase the incidence of hemorrhagic complications.