氯吡格雷联合低分子肝素治疗进展性缺血性脑卒中的临床观察

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1、氯吡格雷联合低分子肝素治疗进展性缺血性脑卒中的临床观察?44?中国现代神经疾病杂志2006年2月第6卷第1期ChinJContempNeuralNeurosurg,Febm!!ol:鱼:!:!氯吡格雷联合低分子肝素治疗进展性缺血脑卒中的临床观察邢志伟史云东【摘要】目的观察氯吡格雷联合低分子肝素治疗进展性缺血性脑卒中的临床疗效和安全性.方法6O例急性进展性缺血性脑卒中患者被分为治疗组和对照组,每组各3O例.入院后均在常规应用灯盏细辛素注射液,神经营养剂,尼莫地平,辛伐他汀和通心络治疗的基础上,对照组患者加用阿司匹林150mg,1次/d;治疗组加用氯吡格雷7

2、5mg,1次/d,低分子肝素6150IU,腹部皮下注射,2次/d,连续治疗10d.治疗前及治疗后14d,对两组患者的血小板,凝血酶原时问和活化部分凝血活酶时间及神经功能缺损评分进行评定.结果治疗组患者治疗后神经功能缺损评分为(9.63+3.27)分,对照组(12.43+3.45)分,两组间比较差异具有显着性意义(P<0.05).两组患者血小板,凝血酶原时问和活化部分凝血酶原时间测定值均在正常值范围内,组间比较差异无显着性意义.两组无一例出现明显不良反应.结论氯吡格雷联合低分子肝素治疗进展性缺血性脑卒中疗效确切,安全可靠.【关键词】氯吡格雷脑血管意外

3、肝素,低分子量ClinicalobservationofcombinedclopidogrelandlowmolecularheparininprogressiveischemicstrokeXINGZhi—wei,SHIYun—do,DepartmentofInternalMedicine,MinzuHospital,Tianjin300122,China【Abstract】ObjectiveToobservetheclinicalcurativeeffectandsafetyofclopidogrelcombinedwithlOWmolecularh

4、eparininthetreatmentofpatientswithprogressiveischemicstroke.MethodsSixtypatientswithacuteprogressiveischemicstrokewererandomlydividedintotreatmentandcontrolgroup.eachof30cases.Patientsinbothgroupsweretreatedroutinelywithbreviscapine,neurotmphicagents,nimodipine,sim—vastatinandton

5、gxinluoafteradmission,whilethepatientsincontrolgroupwereadministeredaspirin(150mg)oncedailyfor10d,butpatientsintreatmentgroupwereadministeredclopidogrel(75mg)oncedailyandlowmolecularheparin(6150IU,iH)twicedailyfor10d.Plateletnumber,prothrombintime),activepartialprothrombintime(AP

6、1广I'),neurologicaldeficitSCale(NDS)wereevaluatedineverypatientbeforeand14daf-teradministrationofdrugs.ResultsAftertreatmenttheNDSofpatientsintreatmentgroupWas(9.63+3.27),whilethatincontrolgroupwas(12.43~3.45),therewassignificantdifferencebetweentwogroups(尸<0.05).1'hplateletcou

7、nt.PTandAPI1'ofpatientsinbothgroupswerewithinnormallimitswithoutsignificantdif-ferencebetweentwogroups.Noneofobviousadverseeffectwasfound.Conclusion1'hecurativeeffectofcombinedclopidogrelandlowmolecularheparinintreatmentofpatientswithprogressiveischemiestrokeisdefinite,safeandrel

8、iable.【Keywords】ClopidogrelCerebrovascul