摘要
目的探讨缺血性卒中患者两种二级预防方案下的临床疗效及其脑血管事件发生情况。方法我院收治的146例缺血性卒中患者,按随机数字表法分为对照组和观察组各73例,均给予他汀类药物治疗,对照组另服用阿司匹林治疗,观察组在对照组基础上联合氯吡格雷治疗,两组均持续治疗3个月,观察治疗前后两组血液黏稠度、颈动脉硬化斑块变化,改良Ranking量表(mRS)评分及治疗后1年两组脑血管事件发生情况,随访两组复发率。结果治疗后两组全血黏度、血浆黏度、颈动脉内中膜厚度(IMT)、斑块面积(PA)、mRS评分明显降低,且观察组降低幅度较对照组明显(P<0.05);两组1年脑血管事件发生率比较差异无统计学意义(P>0.05),但观察组随访复发率低于对照组(P<0.05)。结论阿司匹林联合氯吡格雷的二级预防方案在非致残性缺血性卒中患者治疗中较阿司匹林单一药物方案更具优势,联合预防方案在不增加脑血管事件发生率的情况下可有效降低血液黏稠度,改善颈动脉硬化斑块大小和患者预后效果,具有一定安全性。
To explore the clinical efficacy of two types of secondary prevention programs and the occurrence of cerebrovascular events in patients with non-disabling ischemic stroke.One hundred and forty-six patients with non-disabling ischemic stroke treated in our hospital from August 2015 to October 2016 were randomly divided into control or observation group with 73 cases in each group.All patients were treated with statins.The control group was given aspirin while the observation group was additionally given clopidogrelon on the based of the control group.The two groups received 3 months of treatment.The blood viscosity,changes in carotid angiosclerosis plaque and scores of the improved Ranking Scale(mRS)before and after treatment as well as incidence of cerebrovascular events in 1 year were observed in the two groups,and the recurrence rates were followed.After treatment,the whole blood viscosity,plasma viscosity,carotid intima-media thickness(IMT),plaque area(PA)and mRS scores were significantly decreased in the two groups,and the decrease in the observation group was more obvious than that in the control group(P<0.05).There was no significant difference in the incidence of cerebrovascular events in 1 year between the two groups after treatment(P>0.05),but the follow-up recurrence rate was significantly lower in the observation group than that in the control group(P<0.05).The secondary regimen of aspirin combined with clopidogrel is superior to the aspirin single drug regimen in patients with non-disabling ischemic stroke.The combined prophylaxis program can effectively decrease the blood viscosity without increasing the incidence of cerebrovascular events,and decrease the size of carotid atherosclerotic plaque as well as improve the prognosis of patients with certain safety.
作者
陈光艳
莫晔
CHEN Guang-yan;MO Ye(Department of Neurology,General Hospital of Panzhihua Iron and Steel Group,Panzhihua 617000,China)
出处
《实用医院临床杂志》
2018年第2期89-92,共4页
Practical Journal of Clinical Medicine
关键词
缺血性卒中
非致残性
二级预防
疗效
脑血管事件
Ischemic stroke
Non-disabling
Secondary prevention
Efficacy
Cerebrovascular event
