奥扎格雷联合低分子肝素治疗急性脑梗死临床研究

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1、奥扎格雷联合低分子肝素治疗急性脑梗死临床研究作者：孙贵祥，海青单位：江苏省如皋市人民医院神经内科，江苏如皋【摘要】目的：探讨奥扎格雷与低分子肝素联合治疗急性脑梗死的疗效和安全性。方法：将145例急性脑梗死患者分成联合治疗组76例和対照组69例。观察治疗前后血小板计数，血小板聚集率、纤维蛋口原、高切应力、红细胞压积、凝血功能、影像学、卒中量表评分(NIHSS)及生活白理能力，并比较出血的发生率。结果:两组治疗后血小板聚集率(lmin、最大聚集率)差异均有显著性(均PV0.05),联合治疗组作用最明显(PV0.05);联合治疗组血纤维蛋白原水平，血高切应力均降低(

2、P<0.005,P<0.0l)o生活自理能力恢复联合治疗组(71.20%)优于对照组(1&12%)。出血发牛率2组Z间比较差异无显著性(P>0.05)o3个月时2组NIHSS、MBI比较显示联合治疗组神经功能恢复明显优于对照纽.(均P<0.001)o结论:奥扎格雷联合低分子肝素治疗急性脑梗死有明显疗效，且安全性好。【关键词】急性脑梗死扎格雷分子肝素合治疗ClinicalStudyofTreatingacuteCerebralInfarctionbyOzagrelSodiumcombinedwithlow-molecular-weightHepari

3、nSUNGui-xiang,SHENHai-qing(RugaoPeople'sHospital,JiangsuRugao226500,China)Abstract:Objective:ToinvestigatetheeffectandsafetyofOzagrelsodiumcombinedwithlow・molecular・weightheparininthetreatmentofacutecerebralinfarction.Methods:145patientswithacutecerebralinfarctionwereenrolledinthest

4、udyandallthepatientsweredividedintotwogroups:OzagrelsodiumcombinedwithLMWHgroup(n=76)andcontrolgroup(n=69).Plateletcount,bloodviscosity,plateletaggregationtest(PAgT),fibrinogen,coagulationstudiesJmaging,nationalinstitutesofhealthstrokescale(NIHSS)andmodifiedBarthelIndex(MBI)weremeas

5、uredorassessedbeforeandaftertreatment,respectively.Hemorrhagerateasoneofcomplicationwasalsoinvestigated.Results:Aftertreatment,OzagrelsodiumcombinedwithLMWHgroupshowedstrongerinhibitionofplateletaggregation(P<0.05).PlasmafibrinogenleverlsandhighsheerratedecreasedsignificantlyinOz

6、agrelsodiumcombinedwithLMWHgroup(P<0.005,P<0.01).FunctionalrecoveryinOzagrelsodiumcombinedwithLMWHgroup(71.20%)wassuperiortocontrolgroup(18-12%).Therewasnosignificantdifferenceinsystemishemorrhagewiththetwogroups(P&g(;0・05)・Afollowupof3monthsshowedthatthescoresofNIHSSandMBIinO

7、zarelSodiumcombinedwithLMWHgioupwasbetterthancontrolgroup(P&l(;0.001)・Conclusion:OzagrelsodiumcombinedwithLMWHhasaremarkableeffectandnomorehemoirhagicriskinthetherapyofacutecerebralinfarction.Keywords:Acutecerebralinfarction;Ozagrelsodium;Low-molecular-weightHeparin;Combinedtreatmen

8、t抗血小板聚集药在临床上一直广泛用于防