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目的对比不同剂量阿司匹林治疗急性脑梗死的疗效。方法选择2010年1月—2011年10月140例急性脑梗死患者,随机分为治疗组和对照组,两组均给予对症治疗,治疗组患者入院后即刻给予阿司匹林300 mg研碎顿服,之后300 mg/d空腹顿服;对照组患者入院后即刻给予阿司匹林100 mg研碎顿服,之后100 mg/d空腹顿服。比较两组临床疗效、神经功能缺损评分、C反应蛋白浓度、不良反应。结果治疗第7、14、21、28天总有效率治疗组分别为27.1%、61.4%、87.1%、91.4%,对照组分别为21.4%、41.4%、65.7%、67.1%,两组治疗第14、21、28天总有效率比较差异均有统计学意义(均P<0.05)。治疗前两组神经功能缺损评分、C反应蛋白浓度比较差异无统计学意义(P>0.05),治疗第14、21、28天两组神经功能缺损评分、C反应蛋白浓度比较差异均有统计学意义(均P<0.05)。治疗第21天与第28天两组组内总有效率、神经功能缺损评分、C反应蛋白浓度比较差异均无统计学意义(均P>0.05)。治疗组发生胃肠道刺激症状和大便隐血阳性占5.7%,均发生于第21天后;对照组发生胃肠道刺激症状和大便隐血阳性占4.2%,1例发生于第21天前,2例发生于第21天后;两组比较差异无统计学意义(P>0.05)。结论治疗急性脑梗死患者应用阿司匹林300 mg/d比100 mg/d疗效更好,疗程为21 d更合适,既保证疗效,又不增加不良反应。
Objective To compare the efficacy of different doses of aspirin in the treatment of acute cerebral infarction. Methods A total of 140 acute cerebral infarction patients from January 2010 to October 2011 were randomly divided into treatment group and control group. Both groups were given symptomatic treatment. Patients in treatment group were treated with 300 mg of aspirin immediately after admission, 300 mg / d fasting Dayton clothing; patients in the control group were given aspirin 100 mg shredded Dayton immediately after admission, then 100 mg / d fasting Dayton clothes. The clinical efficacy, neurological deficit score, C-reactive protein concentration and adverse reactions were compared between the two groups. Results The total effective rate on the 7th, 14th, 21st and 28th day of treatment was 27.1%, 61.4%, 87.1% and 91.4% in the treatment group and 21.4%, 41.4%, 65.7% and 67.1% in the control group, respectively 14, 21, 28 days total effective rate difference was statistically significant (all P <0.05). There was no significant difference in neurological deficit scores and C-reactive protein concentrations between the two groups before treatment (P> 0.05). There was statistical difference between the two groups in neurological deficit scores and C-reactive protein concentrations on the 14th, 21st and 28th day after treatment Significance (all P <0.05). There was no significant difference in the total effective rate, neurological deficit score and C-reactive protein between the two groups on the 21st and 28th day after treatment (all P> 0.05). The gastrointestinal tract irritation symptom and stool occult blood positive accounted for 5.7% in the treatment group, both of which occurred after the 21th day. The control group had gastrointestinal irritation and fecal occult blood positive accounted for 4.2%, 1 case occurred before the 21st day, 2 cases Occurred in the first 21 days; no significant difference between the two groups (P> 0.05). Conclusion The treatment of acute cerebral infarction patients aspirin 300 mg / d is better than 100 mg / d, the treatment of 21 d is more appropriate to ensure efficacy, without increasing adverse reactions.