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目的探讨普拉格雷与氯吡格雷强化治疗缺血性脑卒中的疗效与安全性。方法选取2011年5月至2013年5月入院的178例急性缺血性脑卒中患者,将患者随机分为两组,观察组患者给予口服普拉格雷片(负荷量/维持量)。对照组患者给予口服氯吡格雷片(负荷量/维持量)。观察两组患者服药前后平均血小板聚集率(MPA)、平均血小板反应指数(PRI)、改良的Rankin量表评分、NIHSS量表评分、BI指数及不良反应情况。结果与对照组相比,观察组患者药物活性代谢物对血小板P2Y12抑制作的峰值出现的更早(P<0.05),改良的Rankin量表评分、NIHSS量表评分、BI指数等日常生活能力与神经功能恢复情况比较,差异无统计学意义(P>0.05)。结论普拉格雷能更快速、持久地发挥抗血小板作用,普拉格雷与氯吡格雷强化治疗急性缺血性脑卒中疗效相当且安全性良好。
Objective To investigate the efficacy and safety of prasugrel and clopidogrel in the treatment of ischemic stroke. Methods A total of 178 acute ischemic stroke patients admitted to hospital from May 2011 to May 2013 were randomly divided into two groups. Patients in the observation group were given oral prasugrel tablets (loading / maintenance). Patients in the control group were given oral clopidogrel tablets (loading / maintenance dose). The mean platelet aggregation (MPA), mean platelet response index (PRI), modified Rankin scale score, NIHSS scale score, BI index and adverse reactions were observed before and after treatment. Results Compared with the control group, the peak of platelet P2Y12 inhibition was observed earlier (P <0.05), the improved Rankin scale score, NIHSS scale score, BI index, and other daily living ability There was no significant difference in the recovery of neurological function (P> 0.05). Conclusion Prasugrel can exert anti-platelet effect more rapidly and persistently. Prasugrel and clopidogrel are effective and safe in the treatment of acute ischemic stroke.