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目的观察氯吡格雷联合前列地尔治疗大脑中动脉狭窄引起的急性脑梗死的临床疗效和安全性。方法 108例大脑中动脉狭窄引起的脑梗死患者随机分为对照组和试验组,各54例。对照组给予常规补液治疗,同时口服阿司匹林肠溶片100 mg,每天1次;试验组给予常规补液治疗,同时口服氯吡格雷75 mg,静脉注射前列地尔10μL,每天1次,2组疗程均为14 d。治疗7,14 d后,用美国国立卫生研究院卒中量表(NIHSS)评分和日常生活活动能力评分(ADL)评价2组患者的恢复情况。治疗14 d后,检测患者的血浆黏度、血浆纤维蛋白原及血小板聚集率等血流动力学的指标,同时,比较2组不良反应发生情况。结果与治疗前相比,2组治疗后临床症状显著改善(P<0.05);试验组NIHSS评分、ADL评分显著优于对照组(P<0.05)。试验组总有效率为94.4%,显著高于对照组的79.6%(P<0.05);痊愈率(27.8%)显著高于对照组(11.1%,P<0.05)。试验组血流动力学指标的恢复显著优于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论氯吡格雷联合前列地尔治疗大脑中动脉狭窄引起的急性脑梗死患者临床疗效显著,能有效改善神经功能恢复,有效恢复脑梗死患者血流动力学指标,控制病情发展,且不增加不良反应的发生率。
Objective To observe the clinical efficacy and safety of clopidogrel combined with alprostadil in the treatment of acute cerebral infarction caused by middle cerebral artery stenosis. Methods A total of 108 patients with cerebral infarction caused by middle cerebral artery stenosis were randomly divided into control group and experimental group, with 54 cases in each group. The control group was given routine rehydration therapy, while oral aspirin enteric-coated tablets 100 mg once daily; the experimental group given conventional rehydration therapy, while oral clopidogrel 75 mg, intravenous alprostadil 10 μL, 1 day, For 14 days. After 7 and 14 days of treatment, the NIH Stroke Scale (NIHSS) score and ADL were used to evaluate the recovery of the two groups. After 14 days of treatment, the indexes of hemodynamics, such as plasma viscosity, plasma fibrinogen and platelet aggregation rate, were measured. At the same time, the adverse reactions of two groups were compared. Results Compared with those before treatment, the clinical symptoms of the two groups were significantly improved (P <0.05). The scores of NIHSS and ADL in the experimental group were significantly better than those in the control group (P <0.05). The total effective rate was 94.4% in the experimental group, which was significantly higher than 79.6% in the control group (P <0.05). The cure rate was 27.8% in the experimental group significantly higher than that in the control group (11.1%, P <0.05). The recovery of hemodynamics in the experimental group was significantly better than that in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Clopidogrel and alprostadil are effective in treating acute cerebral infarction caused by middle cerebral artery stenosis, which can effectively improve the recovery of neurological function, effectively restore the hemodynamic parameters of patients with cerebral infarction, control the progression of the disease and not increase the adverse reaction The incidence of.