摘要目的 探讨阿斯匹林联合氯吡格雷治疗急性脑梗死的临床疗效.方法 用随机数字表法将486例急性脑梗死患者分为两组,每组243例,对照组予常规药物和阿斯匹林治疗,治疗组在对照组治疗基础上加用氯吡格雷口服,均监测各系统出血发生情况,同时行凝血指标(TT、PT、APTT、FIB)监测.依据美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损的治疗前及治疗后评分.结果 两组治疗后NIHSS评分降低,治疗组治疗前[(15.04±2.53)分]与治疗后[(6.38±1.19)分]差异有统计学意义(P＜0.05);对照组治疗前[(16.26±2.71)分]与治疗后[(9.45±3.27)分]差异有统计学意义(P＜0.05).治疗组治疗后NIHSS评分[(6.38±1.19)分]与对照组[(9.45±3.27)分]比较,差异有统计学意义(t=8.264,P＜0.05).治疗组总有效率为94.24％,高于对照组的81.48％,差异有统计学意义(x2=11.485,P＜0.05).两组患者均未出现明确的出血反应.两组治疗后凝血指标在相对安全范围内延长,差异均无统计学意义(均P＞0.05).结论 阿斯匹林联合氯吡格雷对急性脑梗死患者是安全有效的抗血小板治疗方案.

abstractsObjective To explore the effect of aspirin combined with clopidogrel bisulfate in the treatment of patients with acute cerebral infarction.Methods 486 patients with acute cerebral infarction were selected and divided into the two groups in accordance with the random number table,243 cases in each group.The control group were given aspirin and conventional medical treatment.The observational group were given aspirin and clopidogrel bisulfate orally,system hemorrhage and TT,PT,APTT,FIB of both group were monitored.The efficacy was analyzed in accordance with the degree of neurological deficits score.Results The NIHSS of the observational group after treatment [(6.38 ± 1.19) points] was significantly lower than that of before [(15.04 ± 2.53) points] (P ＜ 0.05);The NIHSS of the control group after treatment [(9.45 ± 3.27) points] was significantly lower than before [(16.26 ± 2.71) points] (P ＜ 0.05);The NIHSS after treatment in the observational group [(6.38 ± 1.19) points] was significantly lower than that of the control group [(9.45 ± 3.27) points] (t =8.264,P ＜ 0.05).The total effective rate of the observational group was 94.24％,which was significantly higher than 81.48％ of the control group(x2 =11.485,P ＜ 0.05).No system hemorrhage was found in both groups.The coagulation index after treatment was higher than before but still in relatively safe range.There was no significant difference of coagulation index between observational group and control group (all P ＞ 0.05).Conclusion Using aspirin combined with clopidogrel bisulfate in acute cerebral infarction patients is safe and effective.