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目的观察不同剂量阿司匹林联合疏血通治疗老年急性脑梗死的疗效及对超敏C反应蛋白(hsCRP)、D-二聚体、血流指标的影响。方法选择110例符合入组标准的老年急性脑梗死患者作为研究对象,按照随机数字表分为观察组和对照组,各55例。两组均进行常规方法治疗,对照组给予低剂量阿司匹林联合疏血通治疗,阿司匹林100 mg/d,1次/d,疏血通6 ml/d,1次/d;观察组给予高剂量阿司匹林联合疏血通治疗,阿司匹林200 mg/d,1次/d,疏血通6 ml/d,1次/d,两组均治疗14 d,治疗前后进行NIHSS评分,空腹抽血检测血流变学指标、hs-CRP及D-二聚体的水平,评价两组临床疗效,记录不良反应发生情况。采用SPSS 17.0统计软件进行统计分析,计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05表示差异有统计学意义。结果观察组和对照组治疗后NIHSS评分、全血低切黏度、全血高切黏度、血浆比黏度、hs-CRP、D-二聚体均治疗前明显降低(均P<0.05),观察组治疗后NIHSS评分、hs-CRP明显低于对照组(均P<0.05);观察组总有效率92.73%与对照组的81.82%比较,差异有统计学意义(χ2=7.852,P<0.05),观察组和对照组的不良反应发生率分别为7.27%(4/55)比5.45%(3/55),差异无统计学意义(χ2=0.153,P>0.05)。结论 200 mg/d阿司匹林联合疏血通能明显改善老年急性脑梗死患者神经功能缺损症状,改善临床预后,有效提高临床疗效,可能与其降低血黏度、预防血栓形成、抑制炎症反应有关,是治疗老年急性脑梗死的理想方法。
Objective To observe the effects of different doses of aspirin combined with Shuxuetong in the treatment of senile acute cerebral infarction and its effect on hsCRP, D-dimer and blood flow index. Methods A total of 110 elderly patients with acute cerebral infarction who met the inclusion criteria were selected as study subjects and divided into observation group and control group according to random number table. The patients in the control group were treated with low-dose aspirin combined with Shuxuetong, aspirin 100 mg / d, once a day, and shuxuetong 6 ml / d, once a day. The patients in the observation group were given high-dose aspirin The combination of Shuxuetong treatment, aspirin 200 mg / d, 1 / d, shuxuetong 6 ml / d, 1 / d, both groups were treated 14 d, NIHSS score before and after treatment, fasting blood test for blood rheology Hs-CRP and D-dimer levels, the clinical efficacy of both groups were evaluated, and the incidence of adverse reactions was recorded. SPSS 17.0 statistical software was used for statistical analysis. The measurement data were expressed as mean ± standard deviation (xˉ ± s), t test was used and the count data (%) was used. Chi-square test was used. P <0.05 was considered statistically significant . Results After treatment, NIHSS score, whole blood low shear viscosity, whole blood high shear viscosity, plasma specific viscosity, hs-CRP and D-dimer were significantly lower in both observation group and control group after treatment (all P <0.05) The NIHSS score and hs-CRP after treatment were significantly lower than those in the control group (all P <0.05). The total effective rate was 92.73% in the observation group compared with 81.82% in the control group, the difference was statistically significant (χ2 = 7.852, P <0.05) Adverse reactions in observation group and control group were 7.27% (4/55) vs 5.45% (3/55) respectively, with no significant difference (χ2 = 0.153, P> 0.05). Conclusion Aspirin combined with Shuxuetong 200 mg / d can significantly improve the symptoms of neurological deficits in elderly patients with acute cerebral infarction, improve clinical prognosis and improve clinical efficacy, which may be related to its effect of lowering blood viscosity, preventing thrombosis and inhibiting inflammatory reaction, Acute cerebral infarction is the ideal method.