阿司匹林加氯吡格雷联合丁苯酞治疗脑梗死患者的疗效和用药安全性及对其血清学指标的影响分析

Analysis of efficacy and medication safety of aspirin combined with clopidogrel in patients with cerebral infarction and its influence on serological indicators

目的评价阿司匹林加氯吡格雷联合丁苯酞治疗脑梗死的可行性,分析其疗效和用药安全性及对患者血清学指标的影响。方法86例脑梗死患者,采用随机法分为对照组和观察组,每组43例。对照组行阿司匹林加氯吡格雷治疗,观察组在对照组基础上联合丁苯酞进行治疗。比较两组患者的治疗效果、不良反应发生情况以及治疗前后的血清学指标[超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)]水平、康复指标[日常生活活动能力量表(ADL)评分、美国国立卫生研究院卒中量表(NIHSS)评分]。结果观察组患者治疗总有效率95.35%高于对照组的79.07%,经统计学计算P<0.05。观察组患者不良反应发生率与对照组相同,经统计学计算P>0.05。治疗后,两组患者的hs-CRP、Hcy、MMP-9水平均低于本组治疗前,且观察组患者hs-CRP(4.28±1.30)mg/L、Hcy(10.58±2.20)μmol/L、MMP-9(138.01±19.80)μg/L低于对照组的(7.30±1.43)mg/L、(15.59±3.01)μmol/L、(182.80±21.01)μg/L,经统计学计算P<0.05。治疗后,两组患者NIHSS评分低于本组治疗前,ADL评分高于本组治疗前,且观察组患者NIHSS评分(10.01±1.01)分低于对照组的(15.30±1.23)分,ADL评分(87.58±5.20)分高于对照组的(72.59±4.01)分,经统计学计算P<0.05。结论阿司匹林加氯吡格雷联合丁苯酞治疗脑梗死患者效果明显,且安全性高,值得推广。

Objective To evaluate the feasibility of aspirin combined with clopidogrel and butylphthalide in the treatment of cerebral infarction,and analyze its efficacy,medication safety and influence on patient's serological indicators.Methods A total of 86 patients with cerebral infarction were selected,and randomly divided into a control group and an observation group,each with 43 patients.The control group was treated with aspirin and clopidogrel,and the observation group was treated with butylphthalide based on the control group.Patients in both groups were compared in terms of treatment effect,adverse reactions,serological indicators[hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),matrix metalloproteinase-9(MMP-9)],rehabilitation indicators[activities of daily living(ADL)score,National Institutes of Health Stroke Scale(NIHSS)score]before and after treatment.Results The total effective rate of the observation group was 95.35%,which was higher than 79.07% of the control group(P<0.05).The incidence of adverse reactions in the observation group was the same as that in the control group(P>0.05).After treatment,the levels of hs-CRP,Hcy and MMP-9 in both groups were lower than those before treatment;the observation group had hs-CRP of(4.28±1.30)mg/L,Hcy of(10.58±2.20)μmol/L and MMP-9 of(138.01±19.80)μg/L,which were lower than(7.30±1.43)mg/L,(15.59±3.01)μmol/L and(182.80±21.01)μg/L in the control group(P<0.05).After treatment,the NIHSS score in both groups was lower than that before treatment,and the ADL score was higher than that before treatment;the observation group had lower NIHSS score of(10.01±1.01)points than(15.30±1.23)points in the control group,and higher ADL score of(87.58±5.20)points than(72.59±4.01)points in the control group(P<0.05).Conclusion The effect of aspirin and clopidogrel in treating patients with butylphthalide is significant and safe,which is worth promoting.