高伟 杨帆 杨柳

【摘要】 目的 探讨奥扎格雷钠联合利伐沙班治疗对急性脑梗死（ACI）患者凝血功能及格拉斯哥昏迷评分（GCS）的影响。

方法 选择2017年12月～2019年12月收治的70例ACI患者，将采用利伐沙班治疗的35例患者纳入对照组，将采用奥扎格雷联合利伐沙班治疗的35例患者纳入观察组。治疗2周后，比较两组临床疗效、凝血功能[凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）]及GCS评分。

结果 治疗2周后，观察组临床疗效优于对照组，差异有统计学意义（P<0.05）。两组PT、APTT、TT均较治疗前上升，FIB均较治疗前降低，观察组改善较对照组大，差异有统计学意义（P<0.05或0.01）。两组GCS评分均较治疗前上升，观察组改善较对照组大，差异有统计学意义（P<0.01）。

结论 奥扎格雷钠联合利伐沙班治疗ACI患者的疗效较好，有利于改善凝血功能，提高GCS评分，促进患者康复。

【关键词】 急性脑梗死;奥扎格雷钠;利伐沙班;凝血功能;格拉斯哥昏迷评分

中圖分类号：R743.33   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.04.008

Effect of ozagrel sodium combined with rivaroxaban on coagulation function and GCS score in patients with acute cerebral infarction

GAO Wei， YANG Fan， YANG Liu

（Department of Neurology， General Hospital of Yima Coal Industry Group Co. LTD， Sanmenxia 472300， Henan， China）

【Abstract】 Objective To investigate the effect of ozagrel sodium combined with rivaroxaban on coagulation function and Glasgow coma score （GCS） in patients with acute cerebral infarction （ACI）.

Methods 70 ACI patients admitted to hospital from December 2017 to December 2019 were selected. 35 patients who were treated with rivaroxaban were included in control group， and 35 patients who were treated with ozagrel combined with rivaroxaban were included in observation group. After 2 weeks of treatment， clinical efficacy， coagulation functions （prothrombin time [PT]， activated partial thromboplastin time [APTT]， thrombin time [TT]， fibrinogen [FIB]） and GCS scores of the two groups were compared.

Results After 2 weeks of treatment， the total effective rate of the observation group was higher than that of the control group， difference was statistically significant （P < 0.05）. The PT， APTT and TT of both groups increased while comparing with those before treatment， the FIB decreased while comparing with that before treatment， and the improvement of the observation group was greater than that of the control group， difference was statistically significant （P < 0.05 or 0.01）. GCS scores of the two groups were higher than before treatment， and the improvement of observation group was greater than that of control group， the difference was statistically significant （P < 0.01）.

Conclusion Ozagrel sodium combined with rivaroxaban is effective in patients with ACI， which is conducive to improving blood coagulation function， improving GCS score， and promoting patient recovery.

【Key words】 ACI; ozagrel sodium; rivaroxaban; coagulation function; GCS

急性脑梗死（ACI）發生后，由于长期缺氧和缺血患者脑细胞会出现不同程度的坏死，导致神经功能缺失，主要临床表现为头痛、眩晕、半身不遂等[1]。目前临床治疗ACI主要以降低凝血功能、抗血小板聚集、恢复脑血流、保护神经细胞等为主[2]。利伐沙班可通过拮抗抗凝血酶Ⅲ抑制Xa因子发挥抗凝作用;奥扎格雷钠具有抗血小板聚集、抑制血栓形成的作用，能够有效改善神经功能缺失情况，已广泛应用于心脑血管疾病，但二者联合应用治疗ACI的研究较少[3～4]。本研究联合奥扎格雷钠与利伐沙班治疗ACI患者，探究该用药方案对凝血功能及格拉斯哥昏迷评分（GCS）的影响，现报告如下。

1 资料与方法

1.1 一般资料

经医学伦理委员会审核通过，选择2017年12月～2019年12月我院收治的70例ACI患者，将采用利伐沙班治疗的35例患者纳入对照组，将采用奥扎格雷联合利伐沙班治疗的35例患者纳入观察组。……