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目的评价蚓激酶联合氯吡格雷治疗糖尿病性急性脑梗死临床疗效和安全性。方法 100例伴糖尿病的急性脑梗死患者,随机分为治疗组和对照组各50例,两组在常规治疗的基础上,对照组单用氯吡格雷75mg,口服,每天1次;治疗组在对照组的基础上加用蚓激酶60万单位,空腹口服,每日3次,连用30天,观察疗效和安全性。两组分别评定神经功能缺损评分及测量血液流变学指标、凝血功能和血小板聚集率。结果治疗30天后,对照组血小板聚集率降低(P<0.05);治疗组血小板聚集率、全血高切、低切粘度、血浆比粘度、全血粘度及纤维蛋白原含量均较治疗前降低(P<0.05);治疗组与对照组比较,血小板聚集率、全血高切、低切粘度、血浆比粘度、全血粘度及纤维蛋白原含量降低(P<0.05);治疗组总有效率(96%)明显高于对照组(88%)(P<0.05)。治疗组治疗期间出现尿隐血1例,无其他不良反应。结论蚓激酶联合氯吡格雷治疗糖尿病急性脑梗死的疗效好,不良反应少。
Objective To evaluate the clinical efficacy and safety of lumbrokinase combined with clopidogrel in the treatment of diabetic acute cerebral infarction. Methods 100 patients with acute cerebral infarction with diabetes were randomly divided into treatment group and control group, 50 cases in each group. On the basis of routine treatment, the control group received clopidogrel 75 mg orally once daily. On the basis of the control group, lumbrokinase was added 600,000 units orally fasting three times daily for 30 days to observe the efficacy and safety. Two groups were assessed neurological deficit score and measurement of hemorheological parameters, coagulation and platelet aggregation rate. Results After 30 days of treatment, the platelet aggregation rate in the control group decreased (P <0.05). The platelet aggregation rate, whole blood high-shear, low shear viscosity, plasma specific viscosity, whole blood viscosity and fibrinogen in the control group decreased (P <0.05). Compared with the control group, the platelet aggregation rate, whole blood high shear, low shear viscosity, plasma specific viscosity, whole blood viscosity and fibrinogen content decreased (P <0.05) 96%) was significantly higher than the control group (88%) (P <0.05). Urine occult blood was found in the treatment group during treatment, with no other adverse reactions. Conclusion Lumbrokinase combined with clopidogrel has a good curative effect in the treatment of diabetic acute cerebral infarction with few adverse reactions.