阿司匹林+氯吡格雷治疗急性脑梗死的效果和安全性

Efficacy and safety of Aspirin and Clopidogrel in the treatment of acute cerebral infarction

目的探讨在治疗急性脑梗死患者中采用阿司匹林联合氯吡格雷后的效果与不良反应。方法选取2018年12月~2020年1月辽宁省健康产业集团铁煤总医院收诊的102例急性脑梗死患者作为研究对象,按照随机数字表法分为观察组(51例)和对照组(51例)。对照组采用阿司匹林进行治疗,观察组采用阿司匹林与氯吡格雷进行治疗,对两组患者经过治疗后的治疗总有效率、美国国立卫生院卒中量表(NIHSS)评分、健康状况问卷(SF-36)评分、血液流变学指标以及不良反应情况进行比较。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组治疗前的NIHSS和SF-36评分比较,差异无统计学意义(P>0.05);治疗后,两组NIHSS评分均低于治疗前,SF-36评分高于治疗前,差异有统计学意义(P<0.05);观察组治疗后的NIHSS评分低于对照组,SF-36评分高于对照组,差异有统计学意义(P<0.05);观察组的红细胞聚集指数低于对照组,血浆黏度、全血低切黏度、花生四烯酸诱导的血小板最大聚集率(MARAA)、二磷酸腺苷诱导的血小板最大聚集率(MARADP)高于对照组,差异有统计学意义(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论对急性脑梗死患者中采用阿司匹林联合氯吡格雷进行治疗,能有效改善血液循环与神经功能,改善临床症状,有助于患者生活质量的提升,具开展价值。

Objective To investigate the effect and adverse reactions of Aspirin combined with Clopidogrel in the treatment of acute cerebral infarction.Methods A total of 102 patients with acute cerebral infarction admitted to the Iron and Coal General Hospital of Liaoning Health Industry Group from December 2018 to January 2020 were selected as the research subjects.According to the random number table method,they were divided into observation group(51 cases)and control group(51 cases).The control group was treated with Aspirin while the observation group was treated with Aspirin and Clopidogrel.After treatment,the total effective rate,the National Institutes of Health Stroke Scale(NIHSS)score,the health status questionnaire(SF-36)scores,hemorheology indexes and adverse reactions were compared between the two groups.Results The total effective rate of observation group was higher than that of control group,the difference was statistically significant(P<0.05).There were no significant differences in NIHSS and SF-36 scores between the two groups before treatment(P>0.05).After treatment,the NIHSS scores of the two groups were lower than those before treatment,and the SF-36 scores were higher than those before treatment,the differences were statistically significant(P<0.05).The NIHSS score of the observation group after treatment was lower than that of the control group,and the SF-36 score was higher than that of the control group,and the differences were statistically significant(P<0.05).The red blood cell aggregation index of the observation group was lower than that of the control group,the plasma viscosity,the low shear viscosity of whole blood,the maximum platelet aggregation induced by arachidonic acid the rate of platelet aggregation(MARAA)and the maximum platelet aggregation rate(MARADP)induced by adenosine diphosphate were higher than those of the control group,and the differences were statistically significant(P<0.05).Comparison of total incidence of adverse reactions between two groups,the difference was not statistically significant(P>0.05).Conclusion The use of Aspirin combined with Clopidogrel in the treatment of patients with acute cerebral infarction can effectively improve blood circulation and nerve function,improve clinical symptoms,and contribute to the improvement of patients'quality of life,which is of development value.