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目的:探讨联合抗栓疗法治疗急性缺血性脑卒中的有效性和安全性。方法 :收集发病在48 h内、未经溶栓治疗的急性缺血性脑卒中患者(NIHSS评分4~20分)120例,分为治疗组和对照组。两组治疗前神经功能NIHSS评分无统计学差异。治疗组用药方案为阿司匹林+阿加曲班+依达拉奉,对照组治疗方案为阿司匹林+三七总皂苷+依达拉奉。观察治疗前、治疗后24 h、48 h、7 d的NIHSS评分,治疗前后CT对比有无出血转化,治疗后90 d生活自理能力m RS评分。结果:两组均未发生出血转化,未发生死亡。治疗组48 h、7 d时NIHSS评分较对照组改善明显(P<0.05)。治疗后90 d时m RS评分治疗组优于对照组(P<0.05)。结论:联合抗栓治疗的早期效果优于单纯抗血小板治疗,能阻止脑梗死急性期的病情进展,其安全性和单纯抗血小板治疗相同。
Objective: To investigate the efficacy and safety of combined antithrombotic therapy in the treatment of acute ischemic stroke. Methods: A total of 120 acute ischemic stroke patients (NIHSS score 4-20) without any thrombolysis within 48 h were collected and divided into treatment group and control group. There was no significant difference in NIHSS score between the two groups before treatment. The treatment regimen was aspirin + argatroban + edaravone, and the control group was aspirin + notoginsenoside + edaravone. The NIHSS scores at 24 h, 48 h and 7 d after treatment were observed before and after treatment. The hemorrhagic transformation was compared between CT before and after treatment, m RS score of self-care ability 90 d after treatment. Results: No hemorrhagic transformation occurred in both groups, and no death occurred. The NIHSS score of the treatment group improved significantly at 48 h and 7 d compared with the control group (P <0.05). At 90 days after treatment, the mRS score in the treatment group was better than that in the control group (P <0.05). CONCLUSION: The combined antithrombotic therapy is superior to antiplatelet therapy alone in preventing the progression of acute cerebral infarction. Its safety is the same as antiplatelet therapy alone.