氯吡格雷联合阿司匹林治疗急性脑梗死伴脑微出血患者的临床效果及安全性探讨(1)
[摘要] 目的 探讨急性脑梗死伴脑微出血患者应用氯吡格雷联合阿司匹林治疗的临床效果及安全性。 方法 根据随机数字表法将方便选取2015年6月—2018年1月59例急性脑梗死伴脑微出血患者分成不同组。对照组给予阿司匹林治疗，观察组则给予阿司匹林联合氯吡格雷治疗。比较两组急性脑梗死伴脑微出血治疗效果：治疗前后患者神经功能缺损评分、生存质量评分；血液流变学指标；药物不良反应率。 结果 治疗2周后，观察组神经功能缺损评分、生存质量评分(0.56±3.21)分、(93.24±2.35)分优于对照组，差异有统计学意义(t=5.521、7.921，P<0.01)。观察组治疗2周后红细胞聚集指数、全血比黏度、血浆比黏度是(9.58±0.21)、(4.18±0.21)mPa/s、(1.62±0.13)mPa/s，优于对照组，差异有统计学意义(t=8.213、9.124、6.542，P<0.01)；治疗2周后观察组药物不良反应率3例(10.00%)和对照组2例(6.90%)差异无统计学意义(χ2=0.211 8，P>0.05)。 结论 急性脑梗死伴脑微出血患者应用阿司匹林联合氯吡格雷治疗效果确切。
[关键词] 氯吡格雷；阿司匹林；急性脑梗死伴脑微出血患者；临床效果；安全性
[中图分类号] R743 [文献标识码] A [文章编号] 1674-0742(2018)11(a)-0004-03
[Abstract] Objective To investigate the clinical efficacy and safety of clopidogrel combined with aspirin in patients with acute cerebral infarction and cerebral microbleeds. Methods According to the random number table method， convenient select 59 patients with acute cerebral infarction and cerebral microbleeds from June 2015 to January 2018 were divided into different groups. The control group was treated with aspirin， and the observation group was given aspirin plus clopidogrel. The therapeutic effects of acute cerebral infarction with cerebral microbleeds were compared between the two groups： neurological deficit score and quality of life score before and after treatment； hemorheology； adverse drug reaction rate. Results After 2 weeks of treatment， the neurological deficit score and quality of life score of (10.56±3.21)points and (93.24±2.35)points were better than the control group， respectively，the different was statistically significant(t=5.521， 7.921， P<0.01). After 2 weeks of treatment， the erythrocyte aggregation index， whole blood specific viscosity， and plasma specific viscosity were (9.58±0.21)， (4.18±0.21)mPa/s， and (1.62±0.13)mPa/s， which were better than the control group，the different was statistically significant(t=8.213， 9.124， 6.542， P<0.01)； After 2 weeks of treatment， there was no significant difference between the adverse drug reaction rate of the observation group 3 cases (10.00%) and the control group 2 cases(6.90%) (χ2=0.211 8， P>0.05). Conclusion The application of aspirin combined with clopidogrel in patients with acute cerebral infarction and cerebral microbleeds is effective.
[Key words] Clopidogrel； Aspirin； Acute cerebral infarction with cerebral microbleeds； Clinical effect； Safety
腦梗死是脑血管疾病中的高发病，多为脑动脉粥样硬化引起的脑血栓形成，患者临床多为急性发作，发病率高，致残率高，死亡率高，且部分患者合并脑微出血，严重威胁患者安全[1-2]，特别是近年来医学影像诊断技术水平突飞猛进，头颅核磁共振磁敏感加权成像技术应用予临床，脑梗死伴微出血患者诊断率明显增加，有研究认为抗血小板药物特别是双联抗血小板药物增加这类患者治疗中脑出血转化风险，带来不良愈后；也有研究认为双联抗血小板药物明确控制脑梗死症状进展，改善脑血流恢复；改善愈后，因此探索有效的药物治疗非常关键。该研究根据随机数字表法将方便选取2015年6月—2018年1月59例该院住院急性脑梗死合并脑微出血患者分成观察组和对照组，旨在探讨氯吡格雷联合阿司匹林治疗急性脑梗死伴脑微出血患者的临床效果及安全性，现报道如下。, http://www.100md.com(赵祥光 张孝良 程冬敏 冯文清)
[关键词] 氯吡格雷；阿司匹林；急性脑梗死伴脑微出血患者；临床效果；安全性
[中图分类号] R743 [文献标识码] A [文章编号] 1674-0742(2018)11(a)-0004-03
[Abstract] Objective To investigate the clinical efficacy and safety of clopidogrel combined with aspirin in patients with acute cerebral infarction and cerebral microbleeds. Methods According to the random number table method， convenient select 59 patients with acute cerebral infarction and cerebral microbleeds from June 2015 to January 2018 were divided into different groups. The control group was treated with aspirin， and the observation group was given aspirin plus clopidogrel. The therapeutic effects of acute cerebral infarction with cerebral microbleeds were compared between the two groups： neurological deficit score and quality of life score before and after treatment； hemorheology； adverse drug reaction rate. Results After 2 weeks of treatment， the neurological deficit score and quality of life score of (10.56±3.21)points and (93.24±2.35)points were better than the control group， respectively，the different was statistically significant(t=5.521， 7.921， P<0.01). After 2 weeks of treatment， the erythrocyte aggregation index， whole blood specific viscosity， and plasma specific viscosity were (9.58±0.21)， (4.18±0.21)mPa/s， and (1.62±0.13)mPa/s， which were better than the control group，the different was statistically significant(t=8.213， 9.124， 6.542， P<0.01)； After 2 weeks of treatment， there was no significant difference between the adverse drug reaction rate of the observation group 3 cases (10.00%) and the control group 2 cases(6.90%) (χ2=0.211 8， P>0.05). Conclusion The application of aspirin combined with clopidogrel in patients with acute cerebral infarction and cerebral microbleeds is effective.
[Key words] Clopidogrel； Aspirin； Acute cerebral infarction with cerebral microbleeds； Clinical effect； Safety
腦梗死是脑血管疾病中的高发病，多为脑动脉粥样硬化引起的脑血栓形成，患者临床多为急性发作，发病率高，致残率高，死亡率高，且部分患者合并脑微出血，严重威胁患者安全[1-2]，特别是近年来医学影像诊断技术水平突飞猛进，头颅核磁共振磁敏感加权成像技术应用予临床，脑梗死伴微出血患者诊断率明显增加，有研究认为抗血小板药物特别是双联抗血小板药物增加这类患者治疗中脑出血转化风险，带来不良愈后；也有研究认为双联抗血小板药物明确控制脑梗死症状进展，改善脑血流恢复；改善愈后，因此探索有效的药物治疗非常关键。该研究根据随机数字表法将方便选取2015年6月—2018年1月59例该院住院急性脑梗死合并脑微出血患者分成观察组和对照组，旨在探讨氯吡格雷联合阿司匹林治疗急性脑梗死伴脑微出血患者的临床效果及安全性，现报道如下。, http://www.100md.com(赵祥光 张孝良 程冬敏 冯文清)