双联抗血小板治疗非轻型缺血性脑卒中的临床效果

Clinical Efficacy of Dual Antiplatelet Therapy for Non Mild Ischemic Stroke

目的:探究双联抗血小板治疗非轻型缺血性脑卒中的临床效果。方法:选取2021年1月—2023年3月萍乡市人民医院神经内科就诊的91例非轻型缺血性脑卒中患者,中途脱落研究的患者共7例,最终84例患者进入研究。根据随机数字表法将患者分为对照组和研究组,各42例。对照组予以阿司匹林肠溶片治疗,研究组予以阿司匹林联合氯吡格雷治疗,并在21 d后改为阿司匹林单抗治疗。观察两组患者的临床效果及治疗前后的神经功能情况、不良事件及卒中复发情况。结果:治疗3个月后,研究组患者的临床有效率为85.71%,显著高于对照组(66.67%),差异有统计学意义(P<0.05)。研究组患者在治疗第7天、第21天、3个月的美国国立卫生研究院卒中量表(NIHSS)评分均低于对照组,差异均有统计学意义(P<0.05)。研究组卒中复发率(2.38%)显著低于对照组(14.29%),差异有统计学意义(P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:双联抗血小板治疗非轻型缺血性脑卒中能较好地改善临床症状,降低卒中复发率,恢复神经功能且并未增加不良事件发生率,疗效及安全性良好。

Objective:To explore the clinical effect of dual antiplatelet therapy in non-mild ischemic stroke.Method:A total of 91 patients with non-mild ischemic stroke treated in the Department of Neurology of Pingxiang People's Hospital from January 2021 to March 2023 were selected.A total of 7 patients dropped out of the study,and 84 patients were enrolled in the study.According to the random number table method,the patients were divided into control group(n=42)and study group(n=42).The control group was treated with Aspirin Enteric-coated Tablets,and the study group was treated with Aspirin combined with Clopidogrel,and the treatment was switched to Aspirin therapy 21 days later.The clinical effect,neurological function,adverse events and stroke recurrence before and after treatment were observed in two groups.Result:After three months of treatment,the clinical effective rate of the study group was 85.71%,which was significantly higher than that of the control group(66.67%),the difference was statistically significant(P<0.05).On the 7th,21th and three months day of treatment,the scores of national institutes of health stroke scale(NIHSS)in the study group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The stroke recurrence rate(2.38%)was significantly lower than that in the control group(14.29%),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse events between two groups(P>0.05).Conclusion:Dual antiplatelet therapy for non-mild ischemic stroke can effectively improve clinical symptoms,reduce stroke recurrence rate,restore neurological function without increasing the incidence of adverse events,and has good efficacy and safety.