早期进展性脑梗死预后的临床研究  

Clinical study on short-term prognosis of early progressive ischemic cerebral stroke

作　　者：杨隽 杨中杰 YANG Jun;YANG Zhongjie(Department of Internal Medicine,First people’s Hospital of Queshan County,Queshan 463200,China;Henan Province Hospital of TCM,Zhengzhou 450000,China)

机构地区：[1]确山县第一人民医院内科,河南确山463200 [2]河南省中医院(河南中医药大学第二附属医院)影像科,河南郑州450000

出　　处：《中国实用神经疾病杂志》2019年第24期2739-2744,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省中医药科学研究专项课题(编号:2019ZY2040)。

摘　　要：目的比较两种方案治疗早期进展性脑梗死治疗的预后情况。方法选择2017-06-2019-10在确山县第一人民医院治疗的52例早期进展性脑梗死患者,随机分为对照组和观察组各26例。2组均采用两种抗血小板聚集药物。对照组采用阿司匹林+氯吡格雷,观察组采用阿司匹林+低分子量肝素钙注射液治疗,比较2组进展后和治疗后神经功能缺损变化,评估临床疗效,并比较2组用药后不良反应情况。结果观察组治疗1周、2周、4周后神经功能缺损评分分别为(27.06±6.08)分、(22.36±4.03)分和(20.36±4.27)分,显著低于对照组的(31.03±4.57)分、(27.03±3.96)分、(26.06±3.27)分,差异有统计学意义(P<0.05)。观察组总有效率(92.31%)显著高于对照组(73.08%),差异有统计学意义(P<0.05)。观察组不良反应发生率(7.69%)与对照组(11.54%)比较无显著差异(P>0.05)。结论早期进展性脑梗死患者采用阿司匹林合+低分子肝素钙进行抗血小板聚集治疗,可有效提升临床疗效,安全性较好,患者预后较好,临床应用价值较高。Objective To compare the short-term prognosis of early progressive ischemic cerebral stroke treated with the two regimens.Methods From June 2017 to February 2019,52 patients with early progressive ischemic cerebral stroke were randomly divided into control group(n=26)and study group(n=26).Both medications of anticoagulant agent and antiplatlet aggregation regimen were used in both groups.The control group was treated with aspirin and clopidogrel.The study group was treated with aspirin and low molecular weight heparin calcium injection.The scores of deficits of neurological function,the clinical efficacy,the short-term prognosis and the adverse reactions were compared between the two groups after the treatments were completed.Results The scores of neurological deficit in the study group(27.06±6.08)points,2 weeks(22.36±4.03)points and 4 weeks after treatment(20.36±4.27)points were significantly lower than those in the control group((31.03±4.57)points(27.03±3.96)points,(26.06±3.27)points,P<0.05).The total effective rate of early progressive ischemic cerebral stroke in the study group(92.31%)was significantly higher than that in the control group(73.08%),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(7.69%)and the control group(11.54%)(P>0.05).Conclusion The treatment of early progressive ischemic cerebral stroke with aspirin combined with low molecular weight heparin calcium can effectively improve the clinical efficacy and safety,the short-term prognosis of the patients is better,and the clinical application value is higher.

关 键 词：进展性脑梗死 低分子肝素 阿司匹林 氯吡格雷 

分 类 号：R743.33[医药卫生—神经病学与精神病学]