方莉伟+郭浩杰

[摘要] 目的 探讨阿司匹林联合氯吡格雷治疗脑梗死的有效性和安全性。 方法 选择68例新发脑梗死患者，分为阿司匹林组（对照组）、氯吡格雷联合阿斯匹林组（治疗组），持续治疗21 d，患者治疗前后分别进行NIHSS评分，并监测治疗前后血清hs-CRP水平。 结果 治疗组总有效率与对照组比较，差异有统计学意义（P<0.05）；治疗组治疗前后血清hs-CRP水平降低程度差异有统计学意义（P<0.05），而对照组差异无统计学意义（P>0.05）。 结论 阿司匹林联合氯吡格雷治疗急性脑梗死的效果明显，临床不良反应少，未见严重出血事件，安全性较高。

[关键词] 阿司匹林；氯吡格雷；脑梗死

[中图分类号] R743[文献标识码] A[文章编号] 1674-4721（2014）03（c）-0076-03

Effect analysis of aspirin combined with clopidogrel in treatment of cerebral infarction

FANG Li-wei GUO Hao-jie

Department of Neurology,Jili District People′s Hospital of Luoyang City, Luoyang 471012,China

[Abstract] Objective To investigate the efficacy and safety of oral administration of aspirin combined with clopidogrel in the treatment of cerebral infarction. Methods Sixty-eight patients with new-onset cerebral infarction were divided into the aspirin group (control group) and the clopidogrel combined with aspirin group (treatment group) and received 21 days of continuous treatment.The patients received pre-treatment and post-treatment NIHSS evaluation and their pre-treatment and post-treatment serum hs-CRP levels were monitored. Results The treatment group and the control group were significantly different in the total effective rate(P<0.05).The pre-treatment serum hs-CRP level and the post-treatment serum hs-CRP level were significantly different in the treatment group (P<0.05),but were not significantly different in the control group (P>0.05). Conclusion Aspirin combined with clopidogrel shows significant efficacy,few clinical adverse reactions and no severe bleeding incident in the treatment of acute cerebral infarction,has high security.

[Key words] Aspirin;Clopidogrel;Cerebral infarction

缺血性脑卒中是目前神经内科最常见的疾病，其致残率和致死率均较高[1]。有效预防和治疗脑梗死，降低脑梗死患者的致残率，对于提高脑梗死患者的生活质量十分重要。本研究将本科2012年3月～2013年3月收治的68例急性脑梗死患者分为阿司匹林组和氯吡格雷联合阿斯匹林组进行对比研究，以探讨阿司匹林联合氯吡格雷治疗急性脑梗死的有效性及安全性。

1 资料与方法

1.1 一般资料

收集本科收治的68例急性脑梗死患者为研究对象，其中男38例，女30例；年龄41～79岁，平均65岁。均为首次发病，起病后72 h内入院，经颅脑CT或MRI检查确诊，均符合1995年全国第四届脑血管病学术会议制订的诊断标准[2]；有氯吡格雷和阿司匹林禁忌证及年龄＞80岁者除外；将68例患者随机分成观察组35例和对照组33例，两组患者的年龄、性别等一般资料差异无统计学意义（P＞0.05），具有可比性。

1.2 方法

68例患者均予以常规降颅内压、调……