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目的探讨阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的临床疗效及安全性。方法回顾性分析上饶县人民医院2015年9月—2016年12月收治的进展性缺血性脑卒中患者104例,随机分为对照组和研究组,各52例。对照组患者给予阿司匹林,研究组患者在对照组基础上给予氯吡格雷治疗,两组均持续治疗30 d。比较两组患者的临床疗效、治疗前及治疗后7、14、30 d卒中评分量表(ESS)评分、日常生活活动能力量表(ADL)及血清超敏C反应蛋白(hs-CRP),观察患者不良反应发生情况。结果研究组患者治疗总有效率高于对照组(P<0.05)。治疗前,两组患者ESS评分比较,差异无统计学意义(P>0.05);治疗后7、14、30 d,研究组患者ESS评分高于对照组(P<0.05)。治疗前及治疗后7 d,两组患者ADL评分比较,差异无统计学意义(P>0.05);治疗后14、30 d,研究组患者ADL评分高于对照组(P<0.05)。治疗前及治疗后7 d,两组患者血清hs-CRP水平比较,差异无统计学意义(P>0.05);治疗后14、30 d,研究组患者血清hs-CRP水平低于对照组(P<0.05)。两组患者均未出现泌尿道出血、皮肤瘀斑、消化道出血等不良反应。结论采用阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的临床疗效确切,可有效改善患者的神经功能,提高其日常生活能力,降低炎性反应,且安全可靠。
Objective To investigate the clinical efficacy and safety of aspirin plus clopidogrel in the treatment of patients with progressive ischemic stroke. Methods A retrospective analysis of 104 patients with progressive ischemic stroke admitted to Shangrao People’s Hospital from September 2015 to December 2016 were randomly divided into control group and study group, with 52 cases in each group. Patients in the control group were given aspirin. Patients in the study group were given clopidogrel on the basis of the control group, and both groups were treated for 30 days. The clinical efficacy, ESR score, ADL and hs-CRP at 7, 14 and 30 days before and after treatment were compared between the two groups. Observe the occurrence of adverse reactions in patients. Results The total effective rate of treatment in study group was higher than that in control group (P <0.05). Before treatment, ESS scores of the two groups had no significant difference (P> 0.05). ESS scores of the study group were higher than those of the control group on the 7th, 14th and 30th day after treatment (P <0.05). There was no significant difference in ADL score between the two groups before treatment and 7 days after treatment (P> 0.05). At 14 and 30 days after treatment, the ADL score of the study group was higher than that of the control group (P <0.05). The levels of hs-CRP in the two groups were not significantly different before treatment and 7 days after treatment (P> 0.05). At 14 and 30 days after treatment, the serum hs-CRP level in the study group was lower than that in the control group <0.05). Two groups of patients did not appear urinary tract bleeding, ecchymoses, gastrointestinal bleeding and other adverse reactions. Conclusion Aspirin plus clopidogrel is effective in treating progressive ischemic stroke. It can effectively improve the neurological function, improve the daily living ability, reduce the inflammatory reaction, and is safe and reliable.