阿司匹林、阿托伐他汀联合氯吡格雷治疗短暂性脑缺血发作的临床疗效分析

摘要

目的：观察阿司匹林、阿托伐他汀联合氯吡格雷治疗短暂性脑缺血发作（TIA）的临床疗效。方法选取2013年2月—2015年2月商洛市中心医院神经内科收治的 TIA 患者150例，根据治疗方法不同分为对照组和观察组，每组75例。两组患者入院后均给予常规对症治疗，对照组患者给予阿司匹林联合阿托伐他汀治疗，观察组患者给予阿司匹林、阿托伐他汀联合氯吡格雷治疗；两组患者均连续治疗3个月。比较两组患者临床疗效、治疗前后凝血功能指标〔凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和纤维蛋白原（FIB）〕及外周血血小板计数（PLT），随访6个月观察患者 TIA 复发及脑梗死情况，记录两组患者治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组（P <0.05）。治疗前，两组患者 PT、APTT、FIB 及外周血 PLT 比较，差异无统计学意义（P >0.05）；治疗后，观察组患者 PT、APTT 长于对照组，FIB、外周血 PLT 低于对照组（P <0.05）。两组患者 TIA 复发率比较，差异无统计学意义（P >0.05）；观察组患者脑梗死发生率低于对照组（P <0.05）。两组患者治疗期间不良反应发生率比较，差异无统计学意义（P >0.05）。结论阿司匹林、阿托伐他汀联合氯吡格雷治疗 TIA 的临床疗效确切，能有效改善患者凝血功能，降低脑梗死发生率，且不良反应少。%Objective To observe the clinical effect of aspirin,atorvastatin combined with clopidogrel on transient ischemic attack. Methods From February 2013 to February 2015,a total of 150 patients with transient ischemic attack were selected in the Department of Neurology,the Central Hospital of Shangluo,and they were divided into control group and observation group according to therapeutic methods, each of 75 cases. Patients of the two groups received conventional symptomatic treatment after admission,meanwhile patients of control group received aspirin and atorvastatin,while patients of observation group received aspirin, atorvastatin combined with clopidogrel; both groups continuously treated for 3 months. Clinical effect,index of coagulation function(PT,APTT and FIB)and peripheral blood PLT before and after treatment were compared between the two groups;all of the patients were followed up for 6 months to observe the recurrence of transient ischemic attack and incidence of cerebral infarction;incidence of adverse reactions was recorded during the treatment. Results Clinical effect of observation group was statistically significantly better than that of control group(P < 0. 05). No statistically significant differences of PT,APTT,FIB or peripheral blood PLT was found between the two groups before treatment( P >0. 05);after treatment,PT and APTT of observation group were statistically significantly longer than those of control group, while peripheral blood PLT and FIB of observation group were statistically significantly lower than those of control group( P <0. 05). No statistically significant differences of recurrence rate of transient ischemic attack was found between the two groups(P> 0. 05),while incidence of cerebral infarction of observation group was statistically significantly lower than that of control group (P < 0. 05). No statistically significant differences of incidence of adverse reactions was found between the two groups during the treatment(P > 0. 05). Conclusion Aspirin,atorvastatin combined with clopidogrel has certain clinical effect in treating transient ischemic attack,can effectively adjust the coagulation function,reduce the incidence of cerebral infarction,with less adverse reactions.