摘要
目的探讨氯吡格雷对老年短暂性脑缺血发作合并意识障碍患者的治疗效果。方法选取2012年6月-2017年6月在辽河油田总医院老年病科接受诊治的老年短暂性脑缺血合并意识障碍患者60例。根据随机数字表法分为两组,每组30例。对照组采用盐酸倍他汀片+阿司匹林的常规治疗,观察组在对照组的基础上给予氯吡格雷治疗,均持续治疗3个月。比较两组治疗后临床疗效、凝血指标及血脂水平[包括总胆固醇(TC),甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)];随访12～48个月,观察两组脑卒中发病情况。结果观察组临床总有效率为96.67%,明显高于对照组的76.67%(χ~2=5.192,P<0.05)。与治疗前相比,两组治疗后APTT、PT明显延长,FIB水平明显下降,且观察组明显优于对照组(P<0.05);两组治疗后GCS评分显著上升,且观察组高于对照组(P<0.05)。与治疗前相比,两组治疗后TC、TG、LDL-C水平均显著下降,且观察组显著低于对照组(P<0.05)。两组治疗后均随访12～48个月,随访期间对照组中有5例(16.67%)出现脑卒中,而观察组中暂无脑卒中病例,观察组预后明显优于对照组(P<0.05);随访期间两组均未出现死亡病例。结论氯吡格雷对老年短暂性缺血合并意识障碍的治疗效果显著,可以降低血脂,有效改善患者的凝血功能及意识状态。
Objective To investigate the clinical efficacy of clopidogrel in elderly patients with transient ischemic attack and consciousness disturbance.Methods Sixty elderly patients with transient cerebral ischemia concomitant with consciousness disturbance treated in the Department of Geriatrics of Liaohe Oilfield General Hospital between June 2012 and June 2017 were selected as the subjects,who were divided into two groups using random number table method,with 30 cases in each group.The control group was given betastatin hydrochloride tablets as routine treatment,while the observation group was additionally given clopidogrel.After treatment of 3 months,the clinical efficacy,coagulation indexes,and levels of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C)were compared between the two groups.Follow-up lasted 12 to 48 months,and the incidence of stroke in the two groups was observed.Results The total clinical effective rate in the observation group was 96.67%,which was significantly higher than that of the control group(76.67%,χ^2=5.192,P<0.05).After treatment,APTT and PT were significantly prolonged,while FIB was significantly decreased,especially in the observation group(P<0.05).The GCS scores in the two groups were increased significantly after treatment,especially in the observation group(P<0.05).After treatment,the levels of TC,TG and LDL-C decreased significantly in the two groups,particularly in the observation group(P<0.05).During the follow-up,5 cases(16.67%)in the control group had stroke,but no stroke occurred in the observation group.The prognosis of the observation group was significantly better than that of the control group(P<0.05),and there was no case of death in either group during the follow-up.Conclusion Clopidogrel is effective for senile transient ischemia with consciousness disturbance by decreasing blood lipids and effectively improving the coagulation function and consciousness state.
作者
徐晓娟
刘姝
刘艳阳
董明
XU Xiaojuan;LIU Shu;LIU Yanyang;DONG Ming(Department of Geriatrics,Liaohe Oilfield General Hospital, Panjin Liaoning 124010,China)
出处
《解放军预防医学杂志》
CAS
2019年第1期46-48,共3页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
2017年度内蒙古自治区卫生计生科研计划项目(No.201703109)
关键词
氯吡格雷
意识障碍
短暂性脑缺血
临床疗效
clopidogrel
consciousness disturbance
transient ischemic attack
clinical efficacy
