双重抗血小板治疗对急性脑梗死合并脑微出血患者的影响.docVIP

双重抗血小板治疗对急性脑梗死合并脑微出血患者的影响 　　[摘要] 目的 探讨阿司匹林联合氯吡格雷双重抗血小板治疗对急性脑梗死合并脑微出血的影响。 方法 选取2013年6月～2015年6月河北省涿州市医院神经内科收治的急性脑梗死合并脑微出血患者133例，依据随机数字表法分为试验组（65例）和对照组（68例）。试验组患者给予阿司匹林联合氯吡格雷进行双重抗血小板治疗，对照组给予阿司匹林抗血小板治疗。观察并比较两组疗效、相关观察指标、不良反应、脑微出血和脑出血性转化情况。 结果 试验组临床疗效总有效率为81.54%，对照组为64.70%，差异有统计学意义（P 0.05），均无出血性转化发生。 结论 阿司匹林联合氯吡格雷双重抗血小板治疗急性脑梗死合并脑微出血的效果好，无明显不良反应，安全性高，不增加脑微出血的发生率和脑出血转化的危险。 　　[关键词] 阿司匹林；氯吡格雷；抗血小板；急性脑梗死；脑微出血 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210（2016）04（b）-0068-04 　　[Abstract] Objective To explore influence of Aspirin joint Clopidogrel dual antiplatelet therapy on patients of acute cerebral infarction combined with cerebral microbleeds. Methods 133 patients with acute cerebral infarction combined with cerebral microbleeds treated by Department of Neurology， Zhuozhou Hospital in Hebei Province from June 2013 to June 2015 were selected and divided into experimental group （65 cases） and control group （68 cases） according to random number table method. Experimental group was treated with Aspirin joint Clopidogrel dual antiplatelet therapy， control group was treated with Aspirin antiplatelet therapy. The effect， laboratory indexes， incidence of adverse events， cerebral microbleeds and incidence of hemorrhagic transformation between two groups were observed and compared. Results Total effective rate was 81.54% in experimental group and total effective rate was 64.70% in control group， with statistical difference （P 0.05）. Two groups had no hemorrhagic transformation. Conclusion Aspirin joint Clopidogrel in the treatment of acute cerebral infarction combined with cerebral microbleeds has good effect， with no significant adverse reactions， security is imperfect， no increase in incidence rate of cerebral microbleeds and the risk of cerebral hemorrhage transformation. 　　[Key words] Aspirin； Clopidogrel； Antiplatelet； Acute cerebral infarction； Cerebral microbleeds 　　急性脑梗死主要由于脑部血液流通不畅，血管闭塞造成，具有发病急、病死率高、致残率高、复发率高的特点，是威胁中老年健康最严重的疾病之一。脑微出血是脑内微小血管病变所致的脑实质亚临床损害，以微小出血和血管周围含铁