氯吡格雷、阿司匹林和辛伐他汀联合首剂负荷量治疗老年急性脑梗死的效果

发布时间：2018-03-07 08:44

本文选题：氯吡格雷　切入点：阿司匹林　出处：《中国老年学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨氯吡格雷、阿司匹林和辛伐他汀联合首剂负荷量治疗老年急性脑梗死的疗效。方法根据84例患者入院顺序随机分为治疗组和对照组,治疗组患者入院时予氯吡格雷300 mg、阿司匹林300 mg和辛伐他汀40 mg顿服后,予氯吡格雷75 mg口服,每晚1次,阿司匹林100 mg口服,每晚1次,辛伐他汀20 mg口服,每晚1次,予长春西汀、血栓通、奥拉西坦静脉常规治疗,同时调整血压和血糖;对照组只予上述常规治疗,2 w后均停用静脉用药。分别于用药前和用药后第2、4周应用美国国立卫生院神经功能缺损程度评分标准(NIHSS)进行神经功能缺损评分、日常生活能力量表(ADL)检测日常生活自理能力,同时检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平、C反应蛋白(CRP)浓度及临床疗效评定。结果两组治疗后NIHSS和ADL评分、CRP浓度、TC、TG、LDL-C均逐渐下降,HDL-C水平逐渐升高,治疗组优于对照组(P0.05),且第4周更加显著(P0.01);治疗组进展性脑梗死发生率明显少于对照组(P0.05);治疗组有效率较高但与对照组无统计学差异(P0.05),且不增加药物副作用。结论氯吡格雷、阿司匹林和辛伐他汀联合首剂负荷量治疗老年急性脑梗死能明显改善患者神经功能缺损症状、提高患者生活自理能力、降低CRP浓度、调整血脂、降低进展性脑梗死发生率,临床疗效较好,且不增加药物的副作用。
[Abstract]:Objective to investigate the efficacy of clopidogrel, aspirin and simvastatin combined with initial dose in the treatment of senile acute cerebral infarction. Methods 84 patients were randomly divided into treatment group and control group according to their admission order. The patients in the treatment group were treated with clopidogrel 300 mg, aspirin 300 mg and simvastatin 40 mg, clopidogrel 75 mg once a night, aspirin 100 mg, once a night, simvastatin 20 mg, once a night. The patients were treated with vinpocetine, Xueshuantong, oxacitam intravenous routine treatment, and blood pressure and blood sugar were adjusted. In the control group, intravenous administration was stopped only after 2 weeks of routine treatment. NIHSS was used to evaluate the neurological impairment before and 2 weeks after treatment. ADL) was used to measure the self-care ability of daily life. At the same time, the levels of serum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured and the clinical efficacy was evaluated. Results NIHSS and ADL scores were evaluated after treatment in both groups. The LDL-C level of TGN decreased gradually and the level of HDL-C increased gradually. The rate of progressive cerebral infarction in the treatment group was significantly lower than that in the control group (P 0.05), but there was no statistical difference between the treatment group and the control group (P 0.05), and the side effects of clopidogrel were not increased. Aspirin and simvastatin combined with first dose in the treatment of elderly patients with acute cerebral infarction can significantly improve the symptoms of neurological impairment, improve the ability of self-care, reduce the concentration of CRP, adjust blood lipid, and reduce the incidence of progressive cerebral infarction. The clinical effect is good and the side effect of the drug is not increased.
【作者单位】：安徽医科大学附属宿州医院宿州市立医院急诊内科;
【分类号】：R743.33

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