依达拉奉联合氯吡格雷治疗急性脑梗死患者疗效及对凝血功能的影响

袁惠清??林金松

[摘要] 目的 為提高急性期脑梗死患者生存质量，观察依达拉奉单药以及联合氯吡格雷用于治疗的有效性。 方法 以2015年7月～2016年9月期间我院收治的110例急性期脑梗死患者为研究对象，将患者按门诊号末位数字单双数分为单药组（单数）、观察组（双数），均为55例。入院后在进行常规神经内科治疗的同时，单药组口服氯吡格雷，观察组在此基础上静脉滴注依达拉奉，对药物治疗疾病效果进行评估，检测用药前后凝血功能指标水平情况，观察患者神经损伤恢复状况。 结果 观察组脑梗死改善率为94.5%，明显高于单药组85.4%，观察组疾病控制、改善效果好，差异具有统计学意义（P<0.05）；入院时凝血功能组间比较差异无统计学意义（P>0.05）；用药后观察组患者凝血指标FIB、PT、APTT、D-D水平依次为（0.82±0.15）、（16.24±2.75） g/L、（26.15±4.74）g/L、（0.67±0.23）mg/L，与单药组（1.35±0.24）g/L、（14.05±2.16）g/L、（23.47±3.58）s、 （0.48±0.14）mg/L比较，观察组改善效果优，差异具有统计学意义（P<0.05）。 结论 为提高治疗急性脑梗死患者生存质量，临床在治疗时将依达拉奉、氯吡格雷合用，能有效改善患者症状、恢复凝血功能，提高疾病治疗效果。

[关键词] 凝血；疗效；急性；依达拉奉；脑梗死；氯吡格雷

[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616（2017）05-59-03

[Abstract] Objective In order to improve the quality of life of patients with acute cerebral infarction， to observe the effect of clopidogrel combined with edaravone in treatment of acute cerebral infarction patients and its impact on coagulation function. Methods 110 cases of acute cerebral infarction patients cured in our hospital from July 2015 to September 2016 were selected as the study objects. According to the number of outpatient patients with single and double figure， they were divided into single drug group （singular） and observation group （odd number） with 55 cases in each. After admission to the conventional neurology treatment， at the same time， patients in single drug group were treated with oral clopidogrel， and patients in observation group were treated with edaravone on the basis of oral clopidogrel. The level of blood coagulation indexes before and after treatment was examined. Recovery after injury was observed. Results The improvement rate of cerebral infarction in the observation group was 94.5%， which was significantly higher than that in the single drug group with 85.4%. The observation group had good effect on disease control and improvement. The differences was statistically significant（P<0.05）. There was no significant difference between the two groups in coagulation function（P>0.05）. After treatment， the coagulation indexes of FIB， PT， APTT and D-D were （0.82±0.15）g/L， （16.24±2.75）g/L， （26.15±4.74）s， （0.67±0.23）mg/L， respectively， after treatment in the observation group. And the coagulation indexes of FIB， PT， APTT and D-D in single drug group were （1.35±0.24）g/L， （14.05±2.16）g/L， （23.47±3.58）s， （0.48±0.14）mg/L. The effect of the observation group was better， the difference was statistically significant （P<0.05）. Conclusion In order to improve the quality of life for patients with acute cerebral infarction， clopidogrel combined with edaravone in clinical treatment can effectively improve the patients symptoms， restore coagulation function， improve the treatment effect of the disease.

[Key words] Blood coagulation； Curative effect； Acute； Edaravone； Cerebral infarction； Clopidogrel

急性脑梗死由于脑血管梗死、脑部局血供障碍，导致组织缺血缺氧、脑组织深部白质梗死，从而对脑实质造成伤害、引发脑部神经损伤，其主要病因为脑血栓的形成。疾病起病迅速、发展快，致死、致残率高[1]。疾病临床表现以患者头痛、晕眩、恶心、肢体偏瘫等为主，若治疗不及时严重者可致意识丧失、昏迷不醒等，临床致死率在4.0%左右，是成人死亡重要因素之一[2]。目前疾病治疗方针为维持患者生命体征平稳，服用溶栓、降压、抗血小板聚集药物，及时有效恢复梗死区血供、减轻神经损害，依达拉奉是临床治疗常用药，能有效清除自由基、阻止血管内细胞损伤，对脑细胞产生保护作用[3]。……