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目的探讨氯吡格雷联合低分子肝素治疗短暂性脑缺血发作(TIA)的临床疗效及安全性。方法选择诊断明确的患者60例随机分成观察组和对照组,两组均予相同的基础治疗。对照组采用肠溶阿司匹林300 mg,1次/d,1周后改为100 mg,1次/d,观察组采用氯吡格雷300 mg首日,继之75 mg,1次/d,共2周,低分子肝素钙5000 U脐周皮下注射,2次/d,共2周,治疗2周评价临床疗效,且检测凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)定量及血小板计数(PLT),并评定。结果观察组:痊愈17例,有效11例,临床总有效率为92.0%,对照组:痊愈9例,有效10例,临床总有效率63.3%,观察组高于对照组,差异具有统计学意义(P<0.01)。观察组和对照组的治疗对凝血指标均无影响(P>0.05)。结论氯吡格雷联合低分子肝素治疗短暂性脑缺血发作具有良好的疗效,安全可行,值得临床推广。
Objective To investigate the clinical efficacy and safety of clopidogrel combined with low molecular weight heparin in the treatment of transient ischemic attack (TIA). Methods Sixty patients with well-defined diagnosis were randomly divided into observation group and control group. Both groups received the same basic treatment. The control group was treated with enteric-coated aspirin 300 mg once daily for 100 mg once a day for one week, followed by clopidogrel 300 mg for the first day followed by 75 mg once daily for 2 days Weeks, low molecular weight heparin 5000 U umbilical subcutaneous injection, 2 times / d, a total of 2 weeks, 2 weeks evaluation of clinical efficacy, and to detect prothrombin time (PT), activated partial prothrombin time (APTT), fiber Protein (FIB) quantification and platelet count (PLT) were also assessed. Results In the observation group, 17 cases were cured and 11 cases were effective. The total clinical effective rate was 92.0%. In the control group, 9 cases were cured and 10 cases were effective. The total clinical effective rate was 63.3%. The observation group was higher than the control group with statistically significant difference (P <0.01). The observation group and the control group had no effect on the coagulation index (P> 0.05). Conclusion Clopidogrel combined with low molecular weight heparin in the treatment of transient ischemic attack has a good effect, safe and feasible, worthy of clinical promotion.