摘要
目的探讨不同剂量氯吡格雷治疗急性脑梗死(CI)患者的效果及安全性。方法选取86例急性CI住院患者,采用简单随机分组法分为大剂量组(n=43)与小剂量组(n=43)。在常规对症治疗基础上,大剂量组给予氯吡格雷150 mg,小剂量组给予氯吡格雷常规剂量75 mg,均持续治疗3个月。比较2组治疗前后血小板计数、血小板聚集率、美国国立卫生研究院卒中量表(NIHSS)评分、预后不良事件发生情况。结果大剂量组治疗后血小板计数、血小板聚集率、NIHSS评分均较治疗前显著下降(P<0.05),且显著低于小剂量组(P<0.05)。大剂量组短期脑梗死复发率2.33%,低于小剂量组9.30%,出血发生率11.63%,高于小剂量组4.65%,差异均无统计学意义(P>0.05)。大剂量组神经功能恶化率4.65%,低于小剂量组18.60%,差异有统计学意义(P<0.05)。结论与标准剂量75 mg氯吡格雷比较,大剂量150 mg氯吡格雷的抗血小板聚集效果更加显著,能有效促进CI患者神经功能恢复。
Objective To investigate the efficacy and safety of different doses of clopidogrel in the treatment of patients with acute cerebral infarction(CI).Methods Totally 86 hospitalized patients with acute CI were randomly divided into high dose group(n=43)and low dose group(n=43).On the basis of routine symptomatic treatment,the high dose group was treated with 150 mg clopidogrel,while the small dose group was treated with 5 mg clopidogrel.All patients were treated for 3 months.The platelet count,platelet aggregation rate,score of National Institute of Health Stroke Scale(NIHSS)before and after treatment as well as adverse events were compared between two groups.Results The platelet count,platelet aggregation rate and NIHSS score in the high dose group were significantly lower than those in the low dose group(P<0.05).The short-term recurrence rate of cerebral infarction was 2.33%in high dose group and 9.30%in low dose group,and the incidence rate of bleeding was 11.63%in high dose group and 4.65%in low dose group,and all these results showed no significant differences(P>0.05).The deterioration rate of neurological function in high dose group was 4.65%,which was significantly lower than 18.60%in low dose group(P<0.05).Conclusion Compared with the standard dose of 75 mg clopidogrel,the high dose of 150 mg clopidogrel has better anti-platelet aggregation effect, which can effectively promote the recovery of neurological function in CI patients.
作者
郑燕红
蔡海明
张旭
ZHENG Yanhong;CAI Haiming;ZHANG Xu(Department of Pharmacy,The 909 th Hospital of Joint Service Support Force of People′s Liberation Army,Southeast Hospital Affiliated to Xiamen University,Xiamen,Fujian,363000;Department of Pediatrics,Zhangzhou Hospital of Fujian Medical University,Zhangzhou,Fujian,363000)
出处
《实用临床医药杂志》
CAS
2019年第22期24-26,共3页
Journal of Clinical Medicine in Practice
关键词
急性脑梗死
氯吡格雷
剂量
抗血小板治疗
神经功能
不良心血管事件
acute cerebral infarction
clopidogrel
dose
anti-platelet therapy
neurological function
adverse cardiovascular events
