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目的探讨缺血性脑卒中患者阿司匹林或氯吡格雷及其联合应用抗血小板治疗的效果。方法将240例患者分为3组,即阿司匹林组(n=48)、氯吡格雷组(n=46)、联合治疗组(n=146)。分别与治疗前及治疗7天后,用血栓弹力图检测患者的花生四烯酸(AA)和二磷酸腺苷(ADP)途径诱导的血小板抑制率。结果 3组AA、ADP途径诱导的血小板抑制率显著高于治疗前(P<0.05)。服用阿司匹林后血小板抑制率高于氯吡格雷(P<0.05)。联合治疗组经AA途径诱导的血小板抑制率(89.4%±20.7%)高于经ADP途径诱导的血小板抑制率(53.4%±22.2%),差异有显著性(P<0.05)。阿司匹林有效率(81.44%)明显高于氯吡格雷(29.69%),差异具有显著性(P<0.05)。结论阿司匹林和氯吡格雷对缺血性脑卒中患者均有显著的抗血小板作用,但阿司匹林效果优于氯吡格雷。
Objective To investigate the effect of aspirin or clopidogrel combined with antiplatelet therapy in patients with ischemic stroke. Methods 240 patients were divided into 3 groups: aspirin group (n = 48), clopidogrel group (n = 46) and combination therapy group (n = 146). The platelet inhibition rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) was measured by thromboelastography before and after treatment for 7 days. Results The inhibitory rates of platelet induced by AA and ADP were significantly higher than those before treatment (P <0.05). After taking aspirin platelet inhibition rate was higher than that of clopidogrel (P <0.05). The platelet inhibition rate (89.4% ± 20.7%) induced by the AA pathway in the combination therapy group was higher than that induced by the ADP pathway (53.4% ± 22.2%). The difference was significant (P <0.05). Aspirin efficiency (81.44%) was significantly higher than clopidogrel (29.69%), the difference was significant (P <0.05). Conclusion Aspirin and clopidogrel have significant antiplatelet effects on patients with ischemic stroke, but aspirin is superior to clopidogrel.