阿司匹林与氯吡格雷联用对患者脑梗死的疗效及其对血液流变学参数和神经功能的影响

The Efficacy of Aspirin in Combination with Clopidogrel in Patients with Cerebral Infarction and its Effect on Hemorheological Parameters and Neurological Function

目的探讨阿司匹林联合氯吡格雷治疗脑梗死的临床疗效及其对患者血液流变学参数和神经功能的影响。方法将100例在2018年6月至2019年7月我院接收的脑梗死患者作为研究样本,随机分为观察组和对照组,各组均纳入50例患者。对照组单用阿司匹林治疗,观察组在对照组的基础上联合应用氯吡格雷治疗。比较两组患者的治疗效果。结果观察组患者的临床治疗总有效率为92%,显著高于对照组(78%),P<0.05,组间差异具有统计学意义。观察组患者的全血比黏度、血浆比黏度、红细胞聚集指数等参数值,均显著低于对照组,P<0.05,组间差异具有统计学意义。两组患者治疗前的NIHSS评分相当,P>0.05,组间差异不具有统计学意义;观察组患者治疗后的NIHSS评分显著低于对照组,P<0.05,组间差异具有统计学意义。观察组患者的胃肠道反应、水肿、头晕等不良反应发生率为16%,与对照组的14%相当,P>0.05,组间差异不具有统计学意义。结论阿司匹林联合氯吡格雷治疗脑梗死能够显著改善患者的血液流变学状态和神经功能缺损情况,从而使患者获得更加显著的临床疗效,且不增加患者的不良反应,安全性较佳。

Objective To investigate the clinical efficacy of aspirin combined with clopidogrel in the treatment of cerebral infarction and its effect on hemorheological parameters and neurological function of patients.Methods One hundred patients with cerebral infarction admitted to our hospital from June 2018 to July 2019 were randomly divided into observation group and control group,50 patients were included in each group.The control group was treated with aspirin alone,while the observation group was treated with clopidogrel on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of the observation group was 92%,which was significantly higher than that of the control group(78%).The whole blood viscosity,plasma viscosity,erythrocyte aggregation index and other parameters in the observation group were significantly lower than those in the control group,and the difference between the P<0.05 groups was statistically significant.The NIHSS scores of patients in the two groups before treatment were the similar,with no statistical significance in P>0.05.The NIHSS score of the observation group after treatment was significantly lower than that of the control group,and the difference between the groups was statistically significant P<0.05.The incidence of gastrointestinal reactions,edema,dizziness and other adverse reactions in the observation group was 16%,which was comparable to 14% in the control group.The difference between the group was not statistically significant P>0.05.Conclusion Aspirin combined with clopidogrel in the treatment of cerebral infarction can significantly improve the hemorheological status and neurological impairment of patients,so that the patients can obtain more significant clinical efficacy,without increasing adverse reactions in patients,and the safety is better.