摘要
目的研究国产氯吡格雷短期联合阿司匹林防止缺血性脑梗死恶化及预防脑梗再发的疗效。方法根据入院顺序,选择因脑梗死初入院的患者84例。随机分为42例。治疗组给予国产氯吡格雷联合阿司匹林治疗7d后改用国产氯吡格雷长期治疗12个月。对照组与治疗组方法相同,仅氯吡格雷采用进口氯吡格雷治疗。观察住院期间病情在2周内持续恶化发生率,并评估患者的神经功能损伤。出院后门诊随访观察患者脑梗死复发情况及残疾功能的改善。结果 21d随访显示,治疗组与对照组脑卒中病情进展恶化分别为19.0%,21.4%,两组比较不具有统计学差异(P>0.05)。入院21d后NIHSS评分分别为9.12±3.12,9.57±3.15,两组比较不具有统计学差异(P>0.05)。长期随访12个月,脑梗死复发率分别为4.7%,4.7%,两组比较不具有统计学差异(P>0.05)。治疗6个月后两组梗死后遗症有明显改善,BI评分分别为37.6±10.3,36.2±10.7,两组比较不具有统计学差异(P>0.05)。二组发生出血的不良反应分别为0%,2.3%,恶心呕吐发生率分别6.4%,6.4%,眩晕、头痛发生率分别为2.3%,2.3%。粒细胞或血小板减少分别为2.3%。两组比较不具有统计学差异(P>0.05)。治疗组无法坚持服用12个月占4.7%,对照组为21.4%,两组比较具有统计学差异(χ2=5.467,P=0.019)治疗组无法坚持服用12个月占4.7%,对照组为21.4%,两组比较具有统计学差异(χ2=7.265,P=0.07)。结论短期应用国产氯吡格雷联合阿司匹林后国产氯吡格雷序贯治疗既可以降低患者入院病情进展风险亦可长期服用降低梗死再发风险。
[ Objective ] To study the short-term domestic clopidogrel in combination with aspirin to prevent deterioration of ischemic stroke and prevention of recurrence of cerebral infarction efficacy. [ Methods ] According to the order of admission to select 84 patients with cerebral infarction due to early admission . Randomly divided into 42 cases . The treatment group received clopidogrel plus aspirin domestic use domestic 21d after long-term treatment with clopidogrel for 12 months . The control group and the treatment group in the same way , only imported clopidogrel clopidogrel . In two weeks, the disease continues to worsen the incidence of hospitalization during the observation and evaluation of patients with neurological damage. Outpatient follow-up after discharge recurrence was observed in patients with cerebral infarction and improve functional disability. [ Results ] 21d follow-up showed that the treatment group and the control group of stroke progression of deterioration were 19.0 %, 21.4%, not statistically different between the two groups （P〉0.05）. 21d after admission NIHSS scores were 9.12 ± 3.12,9.57 ± 3.15, not statistically different between the two groups （P〉0.05）. Long-term follow-up of 12 months, the recurrence of cerebral infarction rates were 4.7%, 4.7%, not statistically different between the two groups （P〉0.05）. After 6 months of treatment groups improved significantly infarction sequela, BI scores were 37.6 ± 10.3, 36.2 ± 10.7, the two groups are not statistically different （P〉0.05）. Two groups of bleeding adverse events were 4.7 %, 6.4%, the incidence of nausea and vomiting were 6.4%, 6.4%, dizziness, headache incidence was 2.3 %, 2.3 %, respectively. Nentropenia or thrombocytopenia were 4.7 %, 4.7 %. No statistical difference between the two groups （P〉0.05）. Treatment group can not insist on taking 12 months, 4.7%, 21.4% in the control group, a significant difference between the two groups （X2=5.467, P=0.019） treatment groups can not insist on taking 12 months accounted for 4.7 % in the control group was 21.4 %, a significant difference between the two groups （X2=7.265, P=0.07）. [ Conclusion ] Short-term application of domestic clopidogrel and aspirin after sequential treatment both domestic clopidogrel reduced the risk of disease progression in patients hospitalized long-term use can reduce infarct recurrence risk.
出处
《中国医学工程》
2015年第2期7-8,11,共3页
China Medical Engineering
