双联抗血小板治疗急性脑梗死伴H型高血压患者的疗效  

Efficacy of Dual Antiplatelet Therapy in Patients with Acute Cerebral Infarction and H-type Hypertension

作　　者：白管兵 潘波 潘娜 BAI Guanbing;PAN Bo;PAN Na(Department of Neurology,No.986th Hospital of the Air Force,Air Force Medical University,Xi'an Shaanxi 710054)

机构地区：[1]空军军医大学空军第九八六医院神经内科,陕西西安710054

出　　处：《医学临床研究》2024年第4期540-543,共4页Journal of Clinical Research

摘　　要：【目的】探讨双联抗血小板治疗急性脑梗死(ACI)伴H型高血压患者的疗效。【方法】本院收治的100例ACI伴H型高血压患者,随机分为观察组和对照组,每组50例。两组患者均给予ACI常规治疗,对照组采用阿司匹林肠溶片抗血小板治疗,观察组在对照组基础上联合应用硫酸氢氯吡格雷片治疗,两组患者均维持治疗8周。比较两组治疗前后美国国立卫生研究院脑卒中量表(NIHSS)评分,治疗后改良Rankin量表(mRS)评分,血小板相关参数、临床疗效及药物相关不良事件。【结果】两组患者治疗后NIHSS评分均显著低于治疗前(P<0.05),且观察组低于对照组(P<0.05);观察组治疗总有效率高于对照组(P<0.05);观察组患者治疗后mRS评分低于对照组(P<0.05)。与治疗前相比,两组患者治疗后同型半胱氨酸(Hcy)、血小板平均体积(MPV)、血小板分布宽度(PDW)均显著降低(P<0.05),且观察组患者治疗后Hcy、MPV及PDW显著低于对照组(均P<0.05)。观察组与对照组出血总发生率比较,差异无统计学意义(P>0.05)。【结论】阿司匹林联合硫酸氢氯吡格雷片用于治疗ACI伴H型高血压患者,能够降低患者的神经功能缺损程度,提高治疗有效率且安全性较高。【Objective】To investigate the efficacy of dual antiplatelet therapy in patients with acute cerebral infarction(ACI)associated with H-type hypertension.【Methods】A total of 100 patients with H-type hypertension related ACI,who received treatment in our hospital,were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received conventional ACI treatment.The control group was treated with aspirin enteric-coated tablets for antiplatelet therapy,while the observation group received a combination of clopidogrel hydrogen sulfate tablets in addition to the control group's treatment.Both groups maintained the treatment for 8 weeks.The NIH Stroke Scale(NIHSS)scores before and after treatment,the modified Rankin Scale(mRS)scores after treatment,platelet-related parameters,clinical efficacy,and drug-related adverse events were compared between the two groups.【Results】After treatment,the NIHSS scores of both groups were significantly lower than before treatment(P<0.05),and the observation group had even lower scores than the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).The mRS scores of patients in the observation group were lower than those in the control group after treatment(P<0.05).Compared with before treatment,the levels of homocysteine(Hcy),mean platelet volume(MPV),and platelet distribution width(PDW)significantly decreased in both groups after treatment(P<0.05),and the levels of Hcy,MPV,and PDW in the observation group were significantly lower than those in the control group after treatment(all P<0.05).There was no significant difference in the total incidence of bleeding between the observation group and the control group(P>0.05).【Conclusion】The combination of aspirin and clopidogrel hydrogen sulfate tablets for the treatment of ACI patients with concurrent H-type hypertension can reduce neurological deficits,improve the treatment effective rate,and is relativ

关 键 词：脑梗死/并发症 急性病 高血压/并发症 血小板聚集抑制剂 治疗结果 

分 类 号：R743.33[医药卫生—神经病学与精神病学]