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目的探讨氯吡格雷联合阿司匹林对进展性缺血性脑卒中患者神经功能及生活能力的影响。方法选取2013年1月至2014年1月揭西县人民医院收治的86例进展性缺血性脑卒中患者作为研究对象,按随机数字表法将其分为对照组与观察组,各43例。对照组患者给予阿司匹林,观察组患者在对照组基础上采用氯吡格雷进行治疗,比较两组患者的临床疗效、治疗前后神经功能缺损情况、生活能力、超敏C-反应蛋白(HS-CRP)水平及不良反应发生情况。结果观察组患者治疗的总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗后7、14、30 d,两组患者的美国国立卫生研究院卒中量表(NIHSS)评分均明显低于治疗前,日常生活能力量表(ADL)评分均明显高于治疗前,均呈时间依赖性,且观察组患者的NIHSS评分均明显低于对照组,ADL评分均明显高于对照组,差异均有统计学意义(均P<0.05);治疗后7、14、30 d,两组患者的血清Hs-CRP水平均明显低于治疗前,呈时间依赖性,且治疗后14 d、30 d,观察组患者的血清Hs-CRP水平均明显低于对照组,差异均有统计学意义(均P<0.05)。结论氯吡格雷联合阿司匹林治疗进展性缺血性脑卒中患者临床效果明显,安全性高,可有效改善患者神经功能缺损情况,减少致残程度,提高其生活能力。
Objective To investigate the effect of clopidogrel combined with aspirin on the neurological function and viability of patients with progressive ischemic stroke. Methods A total of 86 patients with progressive ischemic stroke admitted to the Jiexi County People’s Hospital from January 2013 to January 2014 were selected and divided into control group and observation group according to random number table method, . The patients in the control group were given aspirin. The patients in the observation group were treated with clopidogrel on the basis of the control group. The clinical efficacy, the neurological deficits, the viability, the high-sensitivity C-reactive protein (HS-CRP) Level and adverse reactions occurred. Results The total effective rate of observation group was significantly higher than that of control group (P <0.05). At 7, 14 and 30 days after treatment, the NIH Stroke Scale (NIHSS) The score of ADL was significantly lower than before treatment, the ADL score was significantly higher than before treatment, were time-dependent, and the observation group patients NIHSS scores were significantly lower than the control group, ADL scores were significantly higher (P <0.05). At 7, 14 and 30 days after treatment, the serum Hs-CRP levels in both groups were significantly lower than those before treatment and in time-dependent manner, and after treatment 14 The levels of serum Hs-CRP in the observation group were significantly lower than those in the control group on day d and 30 (all P <0.05). Conclusion Clopidogrel combined with aspirin in the treatment of patients with progressive ischemic stroke has obvious clinical effect and high safety. It can effectively improve the patients’ neurological deficits, reduce the degree of disability and improve their living ability.