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目的分析双抗联合预防合并血管狭窄急性脑卒中后卒中再发风险及患者获益情况。方法选取2014年3月—2015年5月新乡医学院第三附属医院收治的急性脑卒中患者86例为研究对象,均合并血管狭窄,采用随机数表法分为观察组和对照组,每组43例。对照组给予阿司匹林治疗,观察组在此基础上给予氯吡格雷实施双抗联合治疗,均治疗3个月。应用美国国立卫生院神经功能缺损评分表(NIHSS)、卡氏评分表(KPS)比较两组神经功能及生活质量,同时分析其纤维蛋白原(FIB)、超敏C反应蛋白(hs-CRP)水平,并观察两组复发率与不良反应发生率。结果治疗后观察组NIHSS评分(10.14±0.65)分、FIB(1.02±0.14)g/L、hs-CRP(2.41±0.34)mg/L明显低于对照组(P<0.05);观察组KPS评分(89.77±1.54)分高于对照组(76.29±1.32)分(P<0.05);观察组复发率9.3%明显低于对照组25.6%(P<0.05);两组不良反应发生率分别为11.6%、7.0%,差异无统计学意义(P>0.05)。结论合并血管狭窄急性脑卒中后采用阿司匹林与氯吡格雷双抗联合可预防卒中再发,改善患者神经功能、生活能力,值得在临床推广应用。
OBJECTIVE: To analyze the risk of recurrent stroke and the benefit of patients after acute stroke with combined anti-double antibody and anti-stenosis. Methods From March 2014 to May 2015, 86 acute stroke patients admitted to the Third Affiliated Hospital of Xinxiang Medical College were enrolled in the study. All patients were divided into observation group and control group with random number table. Each group 43 cases. The control group was treated with aspirin, and the observation group was treated with clopidogrel on the basis of double-anti-combination therapy, both for 3 months. The neurological deficits and the quality of life of the two groups were compared with NIHSS and KPS. The levels of fibrinogen (FIB), hs-CRP, Level, and observed the recurrence rate and incidence of adverse reactions in both groups. Results After treatment, the NIHSS score (10.14 ± 0.65), FIB (1.02 ± 0.14) g / L and hs-CRP (2.41 ± 0.34) mg / L in the observation group were significantly lower than those in the control group (89.77 ± 1.54) points higher than the control group (76.29 ± 1.32) points (P <0.05). The recurrence rate in the observation group was significantly lower than that in the control group (9.3% vs 25.6%, P <0.05). The adverse reactions rates in the two groups were 11.6 %, 7.0%, the difference was not statistically significant (P> 0.05). Conclusions The combination of aspirin and clopidogrel after acute stroke with vascular stenosis can prevent the recurrence of stroke and improve the neurological function and life expectancy of patients. It is worthy of clinical application.