负荷量氯吡格雷联合阿司匹林治疗再发性脑梗死的临床研究  

Clinical Study of Loading Dose of Clopidogrel Combined with Aspirin for the Treatment of Recurrent Cerebral Infarction

作　　者：杜岩[1] 曲华[1] 

机构地区：[1]沈阳医学院附属第二医院神经内科,沈阳110036

出　　处：《中国医科大学学报》2017年第9期836-838,843,共4页Journal of China Medical University

摘　　要：目的探讨发病24~72 h应用负荷剂量氯吡格雷联合阿司匹林治疗中度再发性脑梗死患者的临床疗效和安全性。方法收集中度再发性脑梗死患者118例,随机分为对照组(58例)和治疗组(60例)。2组于发病24~72 h给药,首日均给予阿司匹林肠溶片(100 mg),治疗组首日加用氯吡格雷片负荷剂量(300 mg),次日给予维持剂量(75 mg)。治疗前后采用美国国立卫生研究院卒中量表(NIHSS)评分;评定2组疗效及出血事件发生率。结果治疗14 d后,治疗组NIHSS评分改善效果明显优于对照组(P<0.05);治疗组总有效率显著高于对照组(P<0.05);2组相比出血事件发生率差异无统计学意义。结论发病24~72 h应用负荷量氯吡格雷联合阿司匹林治疗中度再发性脑梗死,疗效显著,相对安全,应严格掌握治疗指征。Objective To evaluate the safety and efficaey of loading dose of clopidogrel combined with aspirin in treating moderate recurrent cerebral infarction in 24-72 h. Methods In total, 118 patients with moderate recurrent cerebral infarction within the last 24-72 h were randomly divid- ed into the control group （58 patients） and treatment group （60 patients）. For both groups, the loading doses of orally administered aspirin （enteric- coated） and elopidogrel was 100 mg and 300 mg, respectively, on the first day ; a maintenance dose of 75 mg was administered on the next day. The degree of neurological impairment was evaluated using the National Institutes of Health Stroke Scale （NIHSS） before and after 14 d of treatment in the two groups. The safety and ettieacy were also evaluated. Results After 14 d of treatment, the NIHSS score were significantly improved in both groups ; however, the improvement was significantly greater in the treatment group than in the control group （P 〈 0.05 ）. The total effective rate was significantly higher in the treatment group than in the control group （P 〈 0.05）. There was no significant difference in the incidence of bleeding events between the two groups. Conclusion The treatment of moderate recurrent cerebral infarction within 24-72 h, using a loading dose of elopidogrel combined with aspirin, can significantly improve the total effective rate with no significant increase in the incidence of bleeding events. We should strictly control the indications in clinical application process.

关 键 词：氯吡格雷 阿司匹林 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]