盐酸法舒地尔联合氯吡格雷治疗急性脑梗死的临床效果
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摘要
目的探讨盐酸法舒地尔联合氯吡格雷治疗急性脑梗死(ACI)的临床效果。方法选取2016年6月～2018年1月我院收治的180例ACI患者,随机分为对照组和观察组,每组各90例。两组均予以氯吡格雷75 mg,1次/d治疗,观察组在对照组的基础上加用盐酸法舒地尔,两组均予以14 d的治疗,比较两组的临床效果。结果观察组治疗总有效率(85.6%)高于对照组(72.2%),差异有统计学意义(P<0.05);两组治疗后的神经功能缺损(NIHSS)评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组均无严重不良反应。结论盐酸法舒地尔联合氯吡格雷治疗ACI,较单用氯吡格雷效果好,两者在ACI的治疗中能疗效互补,临床上值得推广。
Objective to investigate the effect of Fasudil Hydrochloride combined with Clopidogrel in the treatment of acute cerebral infarction(ACI). Methods A total of 180 patients with ACI in our hospital from June 2016 to January2018 were selected and randomly divided into control group and observation group, 90 cases in each group. The patients of two groups were treated with Clopidogrel 75 mg, qd. The observation group was treated with Fasudil Hydrochloride on the basis of the control group. Both groups were treated for 14 days. The clinical effects of the two groups were compared. Results The total effective rate of the observation group(85.6%) was higher than that of the control group(72.2%), the difference was statistically significant(P<0.05). The scores of neurological deficits in the two groups were lower after treatment, and the observation group was lower than that of the control group, the difference was statistically significant(P<0.05); there was no serious adverse reaction in the two groups during the treatment period. Conclusion Fasudil Hydrochloride combined with Clopidogrel is more effective than Clopidogrel alone in the treatment of ACI. They can complement each other in the treatment of ACI and deserve to be popularized in clinic.
Objective to investigate the effect of Fasudil Hydrochloride combined with Clopidogrel in the treatment of acute cerebral infarction(ACI). Methods A total of 180 patients with ACI in our hospital from June 2016 to January2018 were selected and randomly divided into control group and observation group, 90 cases in each group. The patients of two groups were treated with Clopidogrel 75 mg, qd. The observation group was treated with Fasudil Hydrochloride on the basis of the control group. Both groups were treated for 14 days. The clinical effects of the two groups were compared. Results The total effective rate of the observation group(85.6%) was higher than that of the control group(72.2%), the difference was statistically significant(P<0.05). The scores of neurological deficits in the two groups were lower after treatment, and the observation group was lower than that of the control group, the difference was statistically significant(P<0.05); there was no serious adverse reaction in the two groups during the treatment period. Conclusion Fasudil Hydrochloride combined with Clopidogrel is more effective than Clopidogrel alone in the treatment of ACI. They can complement each other in the treatment of ACI and deserve to be popularized in clinic.
引文
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[18]汪丙松,王佐,徐东,等.法舒地尔对新生大鼠缺氧缺血性脑损伤的脑保护作用[J].实用医学杂志,2015,31(23):3836-3839.
[19]宋明浩,李志祥,马文斌.法舒地尔对脑出血后脑保护作用的临床分析[J].中华神经外科疾病研究杂志,2011,10(5):462-463.
[20]庄靖卿,王小言.尼莫地平联合盐酸法舒地尔对颅内动脉瘤急性出血期SAC术后脑血管痉挛的影响[J].河北医学,2018,24(5):786-790.
[21]石晓明,赵伟,杨永宾,等.法舒地尔联合丹参对下肢动脉硬化闭塞症患者应激状态的影响[J].河北医药,2018,40(4):542-546.
[22]尉杰忠,闫玉清,谷青芳,等.法舒地尔通过促进APP/PS1双转基因小鼠神经再生改善认知功能[J].中国病理生理杂志,2018,34(7):1153-1161.
[2]陈云欢.血小板聚集功能在高血压、高血脂、脑梗死中的应用分析[A]//第一次全国中西医结合检验医学学术会议论文集[C].2014:148-149.
[3]来亚杰,王银平,吴燕.68例脑梗死患者血小板聚集试验的分析[J].中日友好医院学报,2000,14(3):140.
[4]万梅,魏丹,笱玉兰.脑梗死患者抗血小板聚集药物治疗血栓弹力图检测分析[J].湖北民族学院学报(医学版),2018,35(1):14-17.
[5]陈旭翔,谢勇,许子彬,等.氯吡格雷致严重中性粒细胞减少1例[J].岭南急诊医学杂志,2017,22(3):294-295.
[6]钟婉平.氯吡格雷抗血小板效应及药动学的全基因组关联性研究[D].广州:南方医科大学,2017.
[7]林莉.氯吡格雷对急性脑梗死患者血小板膜糖蛋白、血小板聚集率的影响[J].中国临床保健杂志,2009,12(6):639-641.
[8]盛兆雪,赵汉军.替格瑞洛相关呼吸困难的机制与诊治[J].心血管病学进展,2016,37(5):508-511.
[9]邹俊,李欣,邓明凤,等.氯吡格雷血小板反应多样性研究进展[J].药物不良反应杂志,2016,18(1):46-51.
[10]袁冬冬,赵育洁,王军,等.氯吡格雷临床疗效评价及基因影响因素研究[J].中国药物与临床,2015,15(9):1279-1280.
[11]谢霞,张治中,马敏敏,等.缺血性脑卒中氯吡格雷抵抗的研究进展[J].内科急危重症杂志,2014,20(3):145-147.
[12]于江华.大鼠局灶性脑缺血再灌注后脑损伤和促红细胞生成素的脑保护作用[D].石家庄:河北医科大学,2006.
[13]孙伟,刘颖芳,孙跃.丁咯地尔的临床应用[J].社区医学杂志,2007,5(24):18-20.
[14]蒋国红,王长明,徐平,等.ROCK1在大鼠脑缺血再灌注致细胞凋亡中的作用[J].中国老年学杂志,2018,38(2):295-298.
[15]杨锡兰,王盼,董银凤,等.大豆异黄酮和法舒地尔联合应用对大鼠脑缺血再灌注损伤的保护作用[J].蚌埠医学院学报,2016,41(6):712-716.
[16]李丽敏,蒋萍.Rho激酶及其抑制剂在出血性脑血管疾病研究中相关进展[J].国际神经病学神经外科学杂志,2015,42(4):366-369.
[17]刘慧峰,田媛,田福存.尼莫地平与盐酸法舒地尔治疗a SAH后CVS的随机对照研究[J].承德医学院学报,2015,32(5):402-404.
[18]汪丙松,王佐,徐东,等.法舒地尔对新生大鼠缺氧缺血性脑损伤的脑保护作用[J].实用医学杂志,2015,31(23):3836-3839.
[19]宋明浩,李志祥,马文斌.法舒地尔对脑出血后脑保护作用的临床分析[J].中华神经外科疾病研究杂志,2011,10(5):462-463.
[20]庄靖卿,王小言.尼莫地平联合盐酸法舒地尔对颅内动脉瘤急性出血期SAC术后脑血管痉挛的影响[J].河北医学,2018,24(5):786-790.
[21]石晓明,赵伟,杨永宾,等.法舒地尔联合丹参对下肢动脉硬化闭塞症患者应激状态的影响[J].河北医药,2018,40(4):542-546.
[22]尉杰忠,闫玉清,谷青芳,等.法舒地尔通过促进APP/PS1双转基因小鼠神经再生改善认知功能[J].中国病理生理杂志,2018,34(7):1153-1161.