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目的分析双联抗血小板(阿司匹林联合氯吡格雷)治疗短暂性脑缺血发作老年患者的临床疗效。方法 80例短暂性脑缺血发作老年患者,随机分为实验组和对照组,各40例。实验组患者第1天予以氯吡格雷治疗,第2天予以阿司匹林、氯吡格雷,7 d后改氯吡格雷长期维持;对照组患者予以阿司匹林至出院继续服用。随访6个月,比较两组患者的治疗效果。结果对照组有4例复发5次,3例复发1次,2例第2天仍有发作,总复发9例(22.5%);4例单肢无力,3例肢体麻木,2例言语含糊,2例偏瘫,脑梗死相关症状总共发生11例(27.5%)。实验组有1例复发4次,1例复发2次,2例复发1次,总复发4例(10.0%);1例(2.5%)发生偏瘫。实验组总复发率及脑梗死相关症状发生率低于对照组(P<0.05)。结论双联抗血小板对于短暂性脑缺血发作的治疗比单用阿司匹林治疗更有效。
Objective To analyze the clinical efficacy of dual antiplatelet (aspirin plus clopidogrel) in the treatment of elderly patients with transient ischemic attack. Methods Eighty elderly patients with transient ischemic attack were randomly divided into experimental group and control group, 40 cases in each. Patients in the experimental group were treated with clopidogrel on the first day, aspirin and clopidogrel on the second day, and clopidogrel after 7 days. The patients in the control group were treated with aspirin until the patients were discharged. Follow up for 6 months, the treatment effect of two groups of patients was compared. Results In the control group, 4 patients relapsed 5 times, 3 patients relapsed 1 time, 2 patients still had attack on the 2nd day, and 9 patients relapsed (22.5%). Four limbs were weak and three limbs were numb, 2 cases of hemiplegia, cerebral infarction-related symptoms occurred in 11 cases (27.5%). In the experimental group, there was 1 case of recurrence 4 times, 1 case of recurrence 2 times, 2 cases of recurrence 1 time, 4 cases of total recurrence (10.0%) and 1 case (2.5%) of hemiplegia. The total recurrence rate and the incidence of cerebral infarction-related symptoms in the experimental group were lower than those in the control group (P <0.05). Conclusions Dual antiplatelet therapy is more effective than aspirin alone in treating transient ischemic attacks.