阿司匹林与氯吡格雷对急性脑梗死患者NIHSS评分及ADL的影响

Effect of Aspirin Combined with Clopidogrel on NIHSS Score andADL in Patients with Acute Cerebral Infarction

目的:对阿司匹林联合氯呲格雷治疗急性脑梗死(ACI)的疗效进行评价。方法:将100例ACI患者依据随机数字表法分组。对照组(n=50例)行阿司匹林治疗,观察组(n=50例)行阿司匹林+氯呲格雷治疗。观察治疗患者的总有效率;在应用前后,对患者行神经功能缺损(NIHSS)、自理能力(ADL)评分;在应用药物1 d及7 d后,行二磷酸腺苷(ADP)、花生四烯酸(AA)血小板抑制率检测,以观察血小板抑制率的变化,判断是否达标(ADP抑制率≥30%为药物有效,AA抑制率≥50%为药物有效)。结果:观察组患者治疗总有效率(96.00%)高于对照组(80.00%);治疗前,两组ADL、NIHSS评分无统计学意义(P>0.05);治疗1 d后,两组血小板抑制达标率组间相较无统计学意义,治疗7 d后,观察组的血小板抑制达标率高于对照组,ADL评分较治疗前呈现明显增高趋势,NIHSS评分有所降低,观察组优于对照组,两组数据相较具有统计学意义(P<0.05)。结论:阿司匹林联合氯呲格雷能提高ACI的治疗效果,能修复患者的神经功能缺损程度,提高自理能力,对抗血小板聚集,可阻止ACI进展。

Objective:To evaluate the efficacy of aspirin combined with clopidogrel in the treatment of acute cerebral infarction(ACI).Methods:A total of 100 patients with ACI were divided into two groups based on a random number table.The control group(n=50)received aspirin treatment,while the observation group(n=50)received aspirin+clopidogrel treatment.The total effective rate of treatment was observed.Before and after treatment,the patients'neurological impairment(NIHSS)and self-care ability(ADL)scores were assessed.Adenosine diphosphate(ADP)and arachidonic acid(AA)platelet inhibition rates were measured 1 day and 7 days after medication administration to observe changes in platelet inhibition rates and determine whether they met the criteria(ADP inhibition rate≥30%was considered effective,and AA inhibition rate≥50%was considered effective).Results:The total effective rate of treatment in the observation group(96.00%)was higher than that in the control group(80.00%).Before treatment,there were no statistically significant differences in ADL and NIHSS scores between the two groups(P>0.05).One day after treatment,there was no statistically significant difference in the platelet inhibition rate meeting the criteria between the two groups.However,seven days after treatment,the platelet inhibition rate meeting the criteria in the observation group was higher than that in the control group.The ADL scores showed a significant increase trend compared to pre-treatment,and the NIHSS scores decreased.The observation group performed better than the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:Aspirin co-mbined with clopidogrel can improve the therapeutic effect of ACI,repair neurological impairment,en hance self-care ability, inhibit platelet aggregation, and prevent the progression of ACI.