氯吡格雷联合阿司匹林治疗轻中度急性脑梗死的疗效观察

Clinical observation of clopidogrel combined with aspirin in treatment of mild to moderate acute cerebral infarction

目的观察氯吡格雷联合阿司匹林治疗急性脑梗死的临床效果。方法纳入2017年8月—2019年5月在沈阳医学院附属第二医院就诊的急性脑梗死患者180例,随机分为对照组(90例)和治疗组(90例)。对照组口服阿司匹林肠溶片,300 mg/d,治疗14 d后100 mg序贯治疗。治疗组在对照组的基础上口服硫酸氢氯吡格雷片,300 mg/d,次日改为75 mg/d,治疗14 d后,改为阿司匹林100 mg序贯治疗。观察两组患者临床疗效,同时比较治疗前后两组患者美国国立卫生院神经功能缺损评分(NIHSS)和出院6个月后RANKIN量表(m RS)评分。结果治疗后,对照组临床有效率为78.89%,显著低于治疗组的91.11%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分明显下降(P<0.05),且治疗组明显低于对照组(P<0.05)。出院6个月后,两组患者MRS评分明显降低(P<0.05),且治疗组降低更明显(P<0.05)。结论氯吡格雷联合阿司匹林治疗急性脑梗死临床治疗效果显著,具有一定的临床推广应用价值。

Objective To observe the effect of clopidogrel combined with aspirin in treatment of mild to moderate acute cerebral infarction. Methods Patients(180 cases) with mild to moderate acute cerebral infarction in the Second Affiliated Hospital of Shenyang Medical College from August 2017 to May 2019 were randomly divided into control(90 cases) and treatment(90 cases) groups. Patients in the control group were po administered with Aspirin Enteric-coated Tablets, 300 mg/d, then administered sequential therapy with 100 mg after 14 d. Patients in the treatment group were po administered with Clopidogrel Hydrogen Sulphate Tablets on the basis of the control group, 300 mg/d, and 75 mg/d for the second day, then administered sequential therapy with 100 mg Aspirin Enteric-coated Tablets after 14 d. After treatment, the clinical efficacy was evaluated, the NIHSS scores and mRS scores 6 months after discharge in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 78.89%, which was significantly lower than 91.11% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than that in the control group(P < 0.05). After discharge 6 months, the mRS scores in two groups were significantly decreased(P < 0.05), and the scores in the treatment group were significantly lower than that in the control group(P < 0.05). Conclusion Clopidogrel combined with aspirin is effective in treatment of mild to moderate acute cerebral infarction, which has a certain clinical application value.