穿支动脉疾病性脑梗死静脉溶栓后双联抗血小板疗效观察  

Effect of dual antiplatelet therapy after intravenous thrombolysis in patients with penetrating artery territory cerebral infarction

作　　者：郑丽[1] 王聪杰[1] 卢海丽[1] 陈娜[1] 刘珊 李虹[1] 康梅[1] 宋巧[1] 张斌[1] ZHENGLi;WANGCongjie;LU Haili;CHENNa;LIU Shan;LI Hong;KANG Mei;SONGQiao;ZHANG Bin(Department of Neurology,Shijiazhuang First Hospital,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第一医院神经内科,河北石家庄050011

出　　处：《大连医科大学学报》2018年第4期311-314,319,共5页Journal of Dalian Medical University

基　　金：河北省卫计委2017年河北省医学科学研究重点课题计划项目(20170974)

摘　　要：目的观察静脉溶栓对穿支动脉疾病性脑梗死患者的疗效评价及静脉溶栓后进行双联抗血小板治疗的安全性。方法选择2014年12月至2017年6月石家庄市第一医院神经内科三病区住院治疗的穿支动脉疾病性脑梗死患者170例作为研究对象,按治疗方法不同分为3组,对照组单用抗血小板聚集药物阿司匹林治疗,治疗组在对照组基础上给予静脉溶栓治疗,观察组在治疗组基础上联合硫酸氢氯吡格雷抗血小板药物治疗。3个月后比较患者的临床症状改善情况、NIHSS评分、BI指数以及MRS评分变化;观察调节因子超敏C反应蛋白、白介素-6恢复正常比例;并统计出血率、病死率、复发率。结果观察组患者在临床疗效、功能评分、功能评分好转率、调节因子恢复正常比例、病情复发率等指标方面均明显优于对照组和治疗组(均P<0.05)。且对照组患者的脑梗死复发率(30.36%)明显高于治疗组(8.93%)及观察组(5.17%)(P<0.05)。结论静脉溶栓治疗穿支动脉疾病性脑梗死患者能够提高治疗效果,降低复发率,并且双联抗血小板治疗不会增加治疗风险。Objective To investigate the therapeutic effect of intravenous thrombolysis on penetrating artery territory cerebral infarction and the safety of dual antiplatelet therapy after intravenous thrombolysis. Methods One hundred and seventy patients,who had penetrating artery territory cerebral infarction and were treated in the Department of Neurology at First Hospital of Shijiazhuang City from December 2014 to June 2017,were divided into three groups according to different treatment methods. The patients in control group were treated with antiplatelet aggregation aspirin only. The patients in treatment group were treated with intravenous thrombolysis in additional to aspirin therapy. The patients in observation group were treated with antiplatelet drugs in addition to the medication in treatment group. After 3 months of treatment,clinical symptoms,NIHSS score,BI index and MRS score before and after treatment were compared; normalization rate of the regulatory factors high sensitivity C reactive protein and interleukin-6 were observed; the hemorrhage rate,mortality and recurrence rate were calculated. Results In the observation group,the improvement rate of functional score,the functional recovery rate,the normalization ratio of regulating factor and the relapse rate were obviously better than the control group and the treatment group（ P〈0. 05）. The recurrence rate（ 30. 36%） of cerebral infarction of control group were obviously higher than the observation group（ 5. 17%） and the treatment group（ 8. 93%）.Conclusion Intravenous thrombolysis can improve the therapeutic effect and reduce the recurrence rate in patients with penetrating artery territory cerebral infarction. The dual antiplatelet therapy after intravenous thrombolysis does not increase the treatment risk.

关 键 词：穿支动脉 溶栓 静脉 治疗 双联抗血小板 

分 类 号：R743.32[医药卫生—神经病学与精神病学]