氯吡格雷联合阿司匹林治疗急性进展性脑梗死的效果

Effect of Clopidogrel Combined with Aspirin in the Treatment of Acute Progressive Cerebral Infarction

目的:分析急性进展性脑梗死患者采取氯吡格雷与阿司匹林联合治疗的效果。方法:选取2022年1月—2023年4月湛江中心人民医院收治的急性进展性脑梗死患者64例作为研究对象,按照随机抽签法分为观察组与对照组,各32例。对照组采取氯吡格雷治疗,观察组在对照组基础上给予阿司匹林治疗。比较两组临床疗效、血液流变学指标、凝血指标及不良反应的发生情况。结果:观察组临床疗效总有效率高于对照组,差异有统计学意义(P=0.012)。治疗后,两组纤维蛋白原和血浆黏度水平均降低,观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组凝血酶时间(TT)、凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)水平均上升,观察组APTT水平高于对照组,差异有统计学意义(P<0.05);治疗后,两组TT、PT水平比较,差异无统计学意义(P>0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:氯吡格雷联合阿司匹林治疗急性进展性脑梗死的效果显著,有助于改善患者的血液流变学指标及APTT水平,且用药安全性较高,但联合治疗方案对凝血系统激活的抑制作用并不明显。

Objective:To analyze the effect of clopidogrel combined with aspirin in patients with acute progressive cerebral infarction.Methods:Sixty-four patients with acute progressive cerebral infarction admitted to Zhanjiang Central People's Hospital from January 2022 to April 2023 were selected as the study objects,and were divided into observation group and control group according to random drawing method,with thirty-two cases in each group.The control group was treated with clopidogrel,and the observation group was treated with aspirin based on the control group.The clinical efficacy,hemorheology index,coagulation index and the occurrence of adverse reactions were compared between the two groups.Results:The total effective rate of clinical efficacy of the observation group was higher than the control group,and the difference was statistically significant(P=0.012).After treatment,the fibrinogen and plasma viscosity levels of both groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,the levels of thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)in both groups were increased,and the APTT level in observation group was higher than that in control group,with statistical significance(P<0.05);after treatment,there was no significant difference in TT and PT levels between the two groups(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Clopidogrel combined with aspirin has a significant effect in the treatment of acute progressive cerebral infarction,helping to improve the hemorheology indexes and APTT level of patients,and the drug is relatively safe,but the combined treatment regimen has no obvious inhibitory effect on the activation of the coagulation system.