[1]刘 楠.阿司匹林联合氯吡格雷双抗血小板治疗脑梗死的疗效观察及对血清hs-CRP及D-D水平的影响[J].医学信息,2022,35(19):82-84.[doi:10.3969/j.issn.1006-1959.2022.19.022]
　LIU Nan.The Effect of Aspirin Combined with Clopidogrel Dual Antiplatelet Therapy on Cerebral Infarction and its Effect on Serum hs-CRP and D-D Levels[J].Journal of Medical Information,2022,35(19):82-84.[doi:10.3969/j.issn.1006-1959.2022.19.022]
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阿司匹林联合氯吡格雷双抗血小板治疗脑梗死的疗效观察及对血清hs-CRP及D-D水平的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年19期
页码:
82-84
栏目:
论著
出版日期:
2022-10-01

文章信息/Info

Title:
The Effect of Aspirin Combined with Clopidogrel Dual Antiplatelet Therapy on Cerebral Infarction and its Effect on Serum hs-CRP and D-D Levels
文章编号:
1006-1959（2022）19-0082-03
作者:
刘 楠
（佳木斯市中心医院神经内一科，黑龙江 佳木斯 154002）
Author(s):
LIU Nan
(Department of Neurology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)
关键词:
阿司匹林; 氯吡格雷; 双抗; 脑梗死; hs-CRP; D-二聚体
Keywords:
Aspirin; Clopidogrel; Double antibody; Cerebral infarction; hs-CRP; D-dimer
分类号:
R743.3
DOI:
10.3969/j.issn.1006-1959.2022.19.022
文献标志码:
A
摘要:
目的 观察阿司匹林联合氯吡格雷双抗血小板治疗脑梗死的疗效及对血清hs-CRP及D-D水平的影响。方法 选择2018年1月-2021年7月我院诊治的67例脑梗死患者，采用随机数字表法分为对照组（n=34）和观察组（n=33）。对照组采用阿司匹林肠溶片治疗，观察组在对对照组基础上给予氯吡格雷治疗。比较两组临床总有效率、神经功能缺损评分、简易智力（MMSE）评分、日常生活能力评分、凝血功能指标、血清超敏-C反应蛋白（hs-CRP）、D-二聚体（D-D）水平以及临床不良反应发生率。结果 观察组治疗总有效率为93.93%，高于对照组的82.35%（P＜0.05）；两组治疗后神经功能缺损评分均低于治疗前，日常生活能力、MMSE评分均高于对照组，且观察组神经功能缺损评分低于对照组，日常生活能力、MMSE评分高于对照组（P＜0.05）；两组治疗后血浆凝血酶原时间（PT）、活化部分凝血活酶原时间（aPTT）均大于治疗前，纤维蛋白原（FIB）小于治疗前，且观察组PT、aPTT均大于对照组，FIB小于对照组（P＜0.05）；两组治疗后hs-CRP、D-D均低于治疗前，且观察组低于对照组（P＜0.05）；观察组不良反应发生率为6.06%，与对照组的8.82%比较，差异无统计学意义（P＞0.05）。结论 阿司匹林联合氯吡格雷双抗血小板治疗脑梗死效果确切，可提高治疗效果，改善凝血功能，降低神经功能缺损评分，提升日常生活能力和智力水平以及炎性因子指标，且无严重不良反应，具有良好的治疗有效性和安全性。
Abstract:
Objective To observe the effect of aspirin combined with clopidogrel dual antiplatelet therapy on cerebral infarction and its effect on serum hs-CRP and D-D levels.Methods A total of 67 patients with cerebral infarction diagnosed and treated in our hospital from January 2018 to July 2021 were selected and divided into control group (n=34) and observation group (n=33) by random number table method. The control group was treated with aspirin enteric-coated tablets, and the observation group was treated with clopidogrel on the basis of the control group. The total clinical effective rate, neurological deficit score, simple intelligence (MMSE) score, daily living ability score, coagulation function index, serum high-sensitivity C-reactive protein (hs-CRP), D-dimer (D-D) level and incidence of clinical adverse reactions were compared between the two groups.Results The total effective rate in observation group was 93.93%, which was higher than 82.35% in control group (P<0.05). After treatment, the neurological deficit scores of the two groups were lower than those before treatment, and the daily living ability and MMSE scores were higher than those of the control group, while the neurological deficit score of the observation group was lower than that of the control group, and the daily living ability and MMSE score were higher than those of the control group (P<0.05). After treatment, the plasma prothrombin time (PT) and activated partial thromboplastin time (aPTT) in the two groups were higher than those before treatment, and the fibrinogen (FIB) was lower than that before treatment, while the PT and aPTT in the observation group were higher than those in the control group, and FIB was lower than that in the control group (P<0.05). After treatment, hs-CRP and D-D in the two groups were lower than those before treatment, and the observation group was lower than the control group (P<0.05). The incidence of adverse reactions in the observation group was 6.06%, which was compared with 8.82% in the control group, the difference was not statistically significant (P>0.05).Conclusion Aspirin combined with clopidogrel dual antiplatelet therapy is effective in the treatment of cerebral infarction, which can improve the therapeutic effect, improve coagulation function, reduce neurological deficit score, improve daily living ability and intelligence level and inflammatory factor index, and has no significant adverse reactions. It has good therapeutic effectiveness and safety.

参考文献/References:

[1]Finn C,Giambrone AE,Gialdini G,et al.The association between carotid artery atherosclerosis and silent brain infarction: a systematic review and meta-analysis[J].J Stroke Cerebrovasc Dis,2017,26(7):1594-1601.[2]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国无症状脑梗死诊治共识[J].中华神经科杂志,2018,51(9):692-698.[3]李虹,陈娜,陆连生,等.静脉溶栓后行双重抗血小板治疗轻型缺血性卒中患者效果观察[J].疑难病杂志,2017,16(5):445-448.[4]王挺刚,桂树华,狄美琪,等.阿司匹林、氯吡格雷联合疏血通注射液治疗急性脑梗死的临床效果及对血液流变学的影响[J].临床误诊误治,2019,32(1):54-57.[5]Gupta A,Giambrone AE,Gialdini G,et al.Silent brain infarction and risk of future stroke: a systematic review and meta-analysis[J].Stroke,2016,47(3):719-725.[6]张晓艳,沈建昀,张生,等.阿托伐他汀联合氯吡格雷对颅内大动脉狭窄进展性脑梗死患者临床疗效[J].海南医学院学报,2017,23(12):1726-1729.[7]庾建英,李妍慧,付玉华.急性脑梗死合并阻塞性睡眠呼吸暂停低通气综合征患者认知功能的动态观察[J].实用老年医学,2016,30(9):752-755.[8]刘丽丹,田新玮,刘文萍,等.拜阿司匹林联合氯吡格雷在急性脑梗塞中的应用对CD-63、CD62P和PAC-1以及炎性因子、血小板聚集功能的影响[J].中国卫生检验杂志,2018,28(3):332-334,337.[9]卢丽敏,武一平,林杰,等.氢氯吡格雷联合拜阿司匹林治疗脑梗死的疗效及安全性评价[J].中国实用神经疾病杂志,2016,18(7):32-33.[10]张恒建,王勇胜.阿替普酶静脉溶栓治疗对急性脑梗死病人神经功能、凝血功能及炎症应激反应的影响[J].海南医学,2018,29(19):2752-2754.[11]马志刚,闫立荣,唐澍.不同剂量阿托伐他汀联合氯吡格雷治疗脑梗死的疗效及对凝血功能和hs-CRP的影响[J].广西医科大学学报,2017,34(3):398-402.[12]饶子龙,郑华光,王菲,等.血栓弹力图凝血酶原通道检测指标在评价急性缺血性脑血管病病人高血小板反应性以及预测复发缺血事件中的价值[J].中国卒中杂志,2016,11(3):207-214.[13]杨十月.血清hcy、TMA、hs-CRP、copeptib水平变化与急性脑梗死患者病情程度的相关性[J].中国卫生工程学,2017,16(5):666-667,669.[14]林朋兴,陈茂玉.联合抗血小板治疗进展性脑梗死疗效及安全性分析[J].国际医药卫生导报,2016,22(22):3468-3471.[15]刘志君,黄汉烽.氯吡格雷联合阿司匹林对进展性缺血性脑卒中患者神经功能及生活能力的影响[J].中国药物经济学,2016,11(5):41-43.[16]李凤芹.氯吡格雷联合阿司匹林治疗进展性缺血性脑卒中的效果观察[J].河南医学研究,2017,26(9):1645-1646.[17]林彬武,吴明怀,林智强,等.阿司匹林联合氯吡格雷治疗进展型缺血性卒中的疗效分析[J].中国校医,2017,31(1):8-9.[18]何爱芳,宁子秀.阿司匹林联合氯吡格雷治疗进展性脑卒中的疗效评价[J].中国初级卫生保健,2018,32(4):67-69.

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更新日期/Last Update: 1900-01-01