双抗联合短期康复治疗对急性脑梗死患者血液高凝状态的影响

Effect of dual antiplatelet treatment combined with short-term rehabilitation therapy on blood hypercoagulability in patients with acute cerebral infarction

目的分析双抗治疗方案联合短期康复治疗对急性脑梗死患者血液高凝状态的影响。方法选择2018-01—2020-01南充市中心医院急性脑梗死患者213例,依据随机数表分为对照组106例和观察组107例。2组患者均接受短期康复治疗,对照组患者采取阿司匹林肠溶片单抗治疗,观察组患者采取阿司匹林+氯吡格雷双抗治疗。比较2组患者血液流变学、凝血功能、肢体功能和并发症。结果干预后2组患者全血黏度高切变值、血浆黏附、红细胞比积较干预前降低(P<0.05),其中观察组患者全血黏度高切变值、血浆黏附、红细胞比积低于对照组(P<0.05)。干预后2组患者凝血酶原时间、部分凝血活酶时间较干预前增加(P<0.05),纤维蛋白原水平较干预前降低(P<0.05);观察组患者凝血酶原时间、部分凝血活酶时间高于对照组(P<0.05),纤维蛋白原水平低于对照组(P<0.05)。2组患者Barthel指数、FMA评分较干预前增加(P<0.05),观察组患者Barthel指数、FMA评分高于对照组(P<0.05)。并发症发生率方面,观察组患者明显低于对照组(P<0.05)。结论双抗联合短期康复治疗急性脑梗死可有效改善患者血液高凝状态,减少并发症,恢复肢体功能。

Objective To investigate the effect of dual antiplatelet treatment combined with short-term rehabilitation therapy on blood hypercoagulability in patients with acute cerebral infarction.Methods A total of 213 patients with acute cerebral infarction in our hospital from January 2018 to January 2020 were enrolled,and were divided into two groups by random number table methods.Both groups received short-term rehabilitation treatment,based on this,control group(n=106)received aspirin enteric coated tablets with monoclonal antibody,while observation group(n=107)received dual antiplatelet treatment with aspirin+clopidogrel.Then the hemorheology,coagulation function,limb function and complications were compared between groups.Results After intervention,the high shear value of whole blood viscosity,plasma adhesion and hematocrit were decreased in both groups(P<0.05),and were lower in observation group than in control group(P<0.05).After intervention,there was an increase in prothrombin time and partial pro⁃thrombin time in both groups(P<0.05)and a decrease in fibrinogen level(P<0.05);both changes were more significant in observa⁃tion group than those in control group(P<0.05).Barthel index and FMA scores were increased in both groups after intervention(P<0.05),and were higher in observation group than in control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).Conclusion Dual antiplatelet treatment combined with short-term rehabilitation therapy can ef⁃fectively ameliorate the hypercoagulability and promote the recovery of limb function in patients with acute cerebral infarction,with low complication rate.