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目的探讨拜阿司匹林联合氯吡格雷对后循环缺血性脑卒中患者血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、纤维蛋白原(FIB)水平变化的影响。方法选择284例后循环缺血性脑卒中患者,按建档顺序分为观察组和对照组,每组142例。对照组予以常规治疗,观察组在对照组的基础上用拜阿司匹林联合氯吡格雷治疗,持续6个月。统计比较两组治疗前、治疗6个月结束时血清TC,TG,LDL-C水平、日常生活能力评分(BI)、神经功能缺损评分(CNS)及血液流变学指标[红细胞压积(HCT)、纤维蛋白原(FIB)、血浆黏度(ηp)、全血低切黏度(ηbl)、全血高切黏度(ηbh)]水平变化情况并观察两组临床疗效和不良反应发生情况。结果观察组治疗后TC,TG,LDL-C,FIB及HCT,ηp,ηbl,ηbh水平均较对照组降低,差异有统计学意义(P<0.05);治疗后,观察组BI评分较对照组提高,CNS评分较对照组降低,差异有统计学意义(P<0.05);经治疗,观察组总有效率85.21%(121/142),高于对照组66.90%(95/142),差异有统计学意义(P<0.05);观察组不良反应发生率9.15%(13/142),与对照组6.34%(9/142)相比,差异无统计学意义(P>0.05)。结论联合应用拜阿司匹林与氯吡格雷治疗后循环缺血性脑卒中疗效显著,能够有效降低患者血脂水平,改善患者血液流变学状态,提升其神经功能及日常生活能力,且具有较高安全性。
Objective To investigate the changes of serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and fibrinogen (FIB) in patients with posterior circulation ischemic stroke after aspirin plus clopidogrel Impact. Methods 284 patients with posterior circulation ischemic stroke were divided into observation group and control group according to the order of filing, with 142 cases in each group. The control group was routinely treated. The observation group was treated with aspirin and clopidogrel on the basis of the control group for 6 months. The levels of serum TC, TG, LDL-C, BI, CNS and hemorrheological indexes [hematocrit (HCT) before treatment and at the end of 6 months of treatment were compared between the two groups ), Fibrinogen (FIB), plasma viscosity (ηp), whole blood low-cut viscosity (ηbl) and whole blood high-cut viscosity (ηbh)] were measured and the clinical efficacy and adverse reactions were observed. Results The levels of TC, TG, LDL-C, FIB, HCT, ηp, ηbl and ηbh in the observation group were significantly lower than those in the control group after treatment (P <0.05). After treatment, the BI scores in the observation group were significantly lower than those in the control group (P <0.05). After treatment, the total effective rate of the observation group was 85.21% (121/142), which was higher than that of the control group (66.90%, 95/142), and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 9.15% (13/142), which was not significantly different from that in the control group (6.34%, 9/142) (P> 0.05). Conclusion The combined application of aspirin and clopidogrel after treatment of ischemic stroke significant effect, can effectively reduce the patient’s blood lipid levels, improve the patient’s blood rheology, enhance their neurological function and daily living ability, and has high safety .