摘要
目的探讨降纤、抗凝、抗血小板联合治疗缺血性进展性脑卒中（PIS）的临床疗效和安全性。方法90例PIS患者随机分为治疗组（47例）和对照组（43例）。对照组采用碟脉灵注射液＋低分子肝素＋奥扎格雷钠治疗，治疗组在上述治疗基础上给予降纤酶治疗。监测血浆纤维蛋白原（Fib）、凝血酶原时间（PT）、部分激活的凝血酶原时间（AFTT）、肝肾功能。治疗14d后评价临床疗效。结果治疗组临床疗效总有效率为89．4％（44／47），显著高于对照组[67．4％（29／43）]（P〈0．05）。治疗后治疗组PT、APIT分别为（19．76±5．53）、（35．43±6．03）s，对照组盯、APTT分别为（17．26±1．49）、（35．71±5．64）s，2组与治疗前比较显著提高（P均〈0．05），而2组组间比较差异无统计学意义（P均〉0．05）；治疗组Fib为（1．51±0．42）g／L，对照组Fib为（3．10±0．69）g／L，治疗组Fib与治疗前及对照组比较显著下降（P均〈0．05），对照组Fib治疗前后差异无统计学意义（P〉0．05）。2组不良临床事件发生率无统计学意义（P〉0．05）。结论采用降纤、抗凝、抗血小板联合治疗PIS具有较好的临床疗效和安全性，值得临床推广应用。
Objective To investigate the clinical efficacy and safety evaluation of fibrinolytic, anticoagulant and antiplatelet drug combination treatment in patients with progressive ischemic stroke （PIS）. Methods Ninety cases with PIS were randomly divided into the treatment group （47 cases） and the control group （43 cases）. The patients in the control group were given combination therapy of Diemailing, Nadroparin calcium and Ozagrel, while the combination therapy of Defibrasc, Diemailing, Nadroparin Calcium and Ozagrel were given in the treatment group. The plasma fibrinogen （ Fib ）, prothrombin time （ PT）, part enabled prothrombin time （ APTT ）, liver and kidney function were observed. The clinical efficacy was evaluated after 14 days treatment. Results After treatment, the total effective rate of the treatment group was 89.4%, which was significantly higher than that of the control group （ 67.4% ） （ P 〈 0. 05 ） . After treatment, the PT and APTT levels of the treatment group were respectively （ 19. 76 ± 5. 53 ） s and （ 35.43± 6. 03 ） s, the control group were respectively （ 17. 26 ± 1.49 ） s and （35.71 ±5. 64）s, the PT and APTT increased significantly compared with the pre-treatment condition in both groups（ P 〈 0. 05 ） ,while the difference between the two groups was not statistically significant （P 〉 0. 05 ）. The Fib level was （1.51 ±0. 42）g/L in the treatment group,and （3.10 ±0. 69） g/L in the control group. In the treatment group the Fib level was significantly lower than the control group and the condition before treatment（ P 〈 0. 05 ）. We found no significant difference between conditions before or after the treatment in the control group （ P 〉 0.05 ）. The incidence of adverse clinical events showed no significantly difference between the treatment group and control （ P 〉 0. 05）. Conclusions Applying of fibrinolytie, anticoagulant and antiplatelet drug combination treatment in patients with PIS has a good efficacy and safety, which is good for clinical application.
出处
《中国综合临床》
2010年第9期940-942,共3页
Clinical Medicine of China
