阿司匹林联合华法林治疗缺血性脑卒中的有效性及对凝血功能的影响

The efficacy of aspirin combined with warfarin in the treatment of ischemic stroke and its influence on blood coagulation function

目的分析阿司匹林联合华法林治疗缺血性脑卒中的有效性及对凝血功能的影响。方法选取2019年10月至2020年12月于本院诊治的70例缺血性脑卒中患者作为研究对象,根据住院病例单双号分为两组,每组35例。所有患者给于常规药物治疗,对照组给予阿司匹林抗血小板治疗,研究组给予阿司匹林联合华法林抗凝治疗,比较两组临床疗效、生命质量、治疗时间、凝血功能指标[D-二聚体(D-D)、凝血酶原时间(PT)、血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]及不良反应。结果研究组治疗总有效率为91.43%,高于对照组的68.57%(P<0.05);治疗后,研究组心理功能、物质功能、社会功能、躯体功能评分均高于对照组,治疗时间短于对照组(P<0.05);治疗后,研究组D-D、FIB均低于对照组,PT、TT、APTT均短于对照组(P<0.05);研究组不良反应发生率为2.85%,低于对照组的25.71%(P<0.05)。结论阿司匹林联合华法林抗凝治疗缺血性脑卒中患者疗效显著,能有效改善患者的凝血功能指标,缩短治疗时间,提高生命质量,且安全性较高,值得临床推广应用。

Objective To analyze the efficacy of aspirin combined with warfarin in the treatment of ischemic stroke and its influence on blood coagulation function.Methods 70 patients with ischemic stroke diagnosed and treated in our hospital from October 2019 to December 2020 were selected as the research subject,and they were divided into two groups according to the number of inpatients,with 35 cases in each group.All patients were treated with conventional drugs,the control group was treated with aspirin antiplatelet therapy,and the study group was treated with aspirin combined with warfarin anticoagulant therapy.The clinical efficacy,quality of life,treatment time,coagulation function indexes(D-dimer[D-D],prothrombin time[PT],thrombin time[TT],activated partial thromboplastin time[APTT],fibrinogen[FIB])and adverse reactions were comparedbetween two groups.Results The total effective rate of the study group was 91.43%,higher than that of the control group(68.57%);After treatment,the scores of psychological function,material function,social function and physical function in the study group were higher than those in the control group,and the treatment time was shorter than that in the control group(P<0.05);After treatment,D-D and FIB levels in the study group were lower than those in the control group,PT,TT and APTT were shorter than those in the control group(P<0.05);The incidence of adverse reactions in the study group was 2.85%,which was lower than 25.71% in the control group(P<0.05).Conclusion Aspirin combined with warfarin antiplatelet therapy has significant effect in the anticoagulation treatment of ischemic stroke patients,which can effectively improve the coagulation function of patients,shorten the treatment time,improve the quality of life,and has high safety,and is worthy of clinical promotion and application.