阿司匹林联合氯吡格雷疗效脑梗死的治疗观察

Observation on efficacy of aspirin combined with clopidogrel in the treatment of cerebral infarction

目的探讨阿司匹林联合氯吡格雷治疗脑梗死的临床疗效。方法90例脑梗死患者,依据奇偶顺序分为联合组和单一组,每组45例。单一组患者给予口服阿司匹林肠溶片治疗,联合组患者给予阿司匹林联合硫酸氢氯吡格雷治疗。比较两组患者临床疗效、不良反应发生情况以及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel评分和同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)水平。结果联合组治疗总有效率97.78%(44/45)高于单一组的80.00%(36/45),差异具有统计学意义(P<0.05)。治疗后,联合组NIHSS评分(5.61±1.08)分低于单一组的(6.54±1.29)分,Barthel评分(69.68±5.72)分高于单一组的(61.84±5.36)分,差异均具有统计学意义(P<0.05)。治疗后,联合组患者Hcy、hs-CRP、MMP-9水平均低于单一组,差异均具有统计学意义(P<0.05)。联合组的不良反应发生率4.44%低于单一组的24.44%,差异具有统计学意义(P<0.05)。结论对脑梗死患者应用阿司匹林联合氯吡格雷治疗方案的临床疗效及安全性更具优势。

Objective To discuss the clinical efficacy of aspirin combined clopidogrel in the treatment of cerebral infarction.Methods A total of 90 patients with cerebral infarction were divided into combination group and single group according to odd-even number method,with 45 cases in each group.The single group was treated with oral aspirin enteric-coated tablets,and the combination group was treated with aspirin and clopidogrel bisulfate.The clinical efficacy,occurrence of adverse reactions,National Institutes of Health stroke scale(NIHSS)score,Barthel score,homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP),and matrix metalloproteinase-9(MMP-9)before and after treatment were compared between the two groups.Results The total effective rate 97.78%(44/45)of the combination group was higher than 80.00%(36/45)of the single group,and the difference was statistically significant(P<0.05).After treatment,the NIHSS score(5.61±1.08)points of the combination group was lower than(6.54±1.29)points of the single group,and Barthel score(69.68±5.72)points was higher than(61.84±5.36)points of the single group.All the difference was statistically significant(P<0.05).After treatment,the levels of Hcy,hs-CRP and MMP-9 of the combination group were lower than those of the single group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions 4.44%of the combination group was lower than 24.44%of the single group,and the difference was statistically significant(P<0.05).Conclusion Combination of aspirin and clopidogrel has better clinical efficacy and safety on patients with cerebral infarction.