郭炜 薛慧芳 魏淑贞 任书亭

[摘要]目的 探討溶栓前服用抗血小板药对脑梗死（CI）患者的治疗效果及预后。方法 选取我院2017年1月～2019年5月收治的120例CI患者作为研究对象，按照溶栓前是否应用抗血小板药分为观察组与对照组各60例，观察组溶栓前已服用抗血小板药，对照组溶栓前未服用抗血小板药，两组患者均进行溶栓治疗。比较两组治疗后1 d和治疗后7 d的疗效、血压、颅内出血及90 d内的预后情况。结果 观察组治疗后1、7 d的良好率分别为63.33%、70.00%，高于对照组的40.00%、45.00%，差异均有统计学意义（P<0.05）;观察组治疗后的血压低于对照组，差异有统计学意义（P<0.05）;两组90 d内预后良好率、病死率、颅内出血率比较，差异均无统计学意义（P>0.05）。结论 溶栓前服用抗血小板药对CI患者的近期治疗效果较好，能明显改善患者的血压，且不会增加颅内出血的发生率，对患者的预后也不会产生显著影响。

[关键词]溶栓;血小板;脑梗死;预后

[中图分类号] R743.1          [文献标识码] A          [文章编号] 1674-4721（2020）7（c）-0073-03

Application effect of antiplatelet drugs in patients with cerebral infarction before thrombolysis

GUO Wei   XUE Hui-fang   WEI Shu-zhen   REN Shu-ting

Department of Neurology， Fuwai Cardiovascular Hospital of Qingdao， Shandong Province， Qingdao   266034， China

[Abstract] Objective To explore the therapeutic effect and prognosis of patients with cerebral infarction （CI） taking antiplatelet drugs before thrombolysis. Methods A total of 120 patients with CI who were admitted to the hospital from January 2017 to May 2019 were selected as the subjects. They were divided into the observation group and the control group according to the use of antiplatelet drugs before thrombolysis，each had 60 cases. Before thrombolysis， the observation group took antiplatelet drugs while the control group did not take. Both groups were treated with thrombolysis therapy. The curative effect at 1 d and 7 d after treatment， blood pressure， intracranial hemorrhage and 90 day prognosis were compared between the two groups. Results The excellent and good rates in the observation group at 1 d and 7 d after treatment （63.33% and 70.00%） were higher than those in the control group （40.00% and 45.00%）. The differences were statistically significant （P<0.05）. After treatment， the blood pressure of observation group was lower than that of control group， the difference was statistically significant （P<0.05）. There were no significant differences in the good rate of 90 day prognosis， mortality rate or rate of intracranial hemorrhage between the two groups（P>0.05）. Conclusion The short-term effect of taking antiplatelet drugs before thrombolysis is good in the treatment of patients with CI. It can significantly improve the blood pressure of patients， without increasing the incidence of intracranial hemorrhage or causing obvious influence on the prognosis.

[Key words] Thrombolysis; Platelet; Cerebral infarction; Prognosis

脑梗死（CI）又称缺血性脑卒中，是一种突然发作的脑部病变[1]。CI多见于中老年人，发病时间为患者睡眠时，其前驱症状（如頭晕、无力等）不明显，易被人们忽视。近年来，随着时代的发展，人们生活习惯的改变，CI的发病率逐年升高，严重影响患者的身心健康。因此对于CI患者必须采取有效的治疗手段，促进患者康复。目前静脉溶栓是治疗CI的首选方法，溶栓药多采用阿替普酶，而临床上对于溶栓前是否应该服用抗血小板药则无统一定论[2]。为此本研究选取本院诊治的120例CI患者开展回顾性分析，探讨溶栓前服用抗血小板药对CI患者的治疗效果及对预后的影响。

1 资料与方法

1.1一般资料