[1]段发亮,黄从刚,倪厚杰,等.阿司匹林联合氯吡格雷治疗缺血性脑卒中的疗效及对血小板聚集率的影响[J].中国临床神经外科杂志,2017,(07):470-472.[doi:10.13798/j.issn.1009-153X.2017.07.008]
 DUAN Fa-liang,HUANG Cong-gang,NI Hou-jie,et al.Curative effect of aspirin combined with plavix on ischemic stroke and its impact on platelet aggregation rate[J].,2017,(07):470-472.[doi:10.13798/j.issn.1009-153X.2017.07.008]
点击复制

阿司匹林联合氯吡格雷治疗缺血性脑卒中的疗效及对血小板聚集率的影响()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年07期
页码:
470-472
栏目:
论著
出版日期:
2017-07-20

文章信息/Info

Title:
Curative effect of aspirin combined with plavix on ischemic stroke and its impact on platelet aggregation rate
文章编号:
1009-153X(2017)07-0470-03
作者:
段发亮黄从刚倪厚杰闵强黄乔春吴京雷王远宋平
430022,武汉市第一医院神经外科(段发亮、黄从刚、闵 强、黄乔春、吴京雷、王 远、宋 平),神经内科(倪厚杰)
通讯作者:黄从刚,E-mail:huangconggang1984@126.com
Author(s):
DUAN Fa-liang1 HUANG Cong-gang1 NI Hou-jie2 MIN Qiang1 HUANG Qiao-chun1 WU Jing-lei1WANG Yuan1 SONG Ping1.
1. Department of Neurosurgery, The First Hospital of Wuhan City, Wuhan 430022, China;
2. Department of Neurology, The First Hospital of Wuhan City, Wuhan 430022, China
关键词:
缺血性脑卒中阿司匹林氯吡格雷血小板聚集率
Keywords:
Ischemic stroke Aspirin Plavix Platelet aggregation Curative effect
分类号:
R 743
DOI:
10.13798/j.issn.1009-153X.2017.07.008
文献标志码:
A
摘要:
目的 探讨阿司匹林联合氯吡格雷治疗缺血性脑卒中的疗效及其病人血小板聚集率的影响。方法 回顾性分析2014年6月至2015年6月收治的292例缺血性脑卒中的临床资料。根据治疗方法分为常规组(146例)与联合组(146例),常规组给予阿司匹林(100 mg/d)治疗,联合组在常规组治疗的基础上给予氯吡格雷(75 mg/d)治疗。治疗前、治疗后2周,比较两组血小板聚集率和美国国立卫生研究所脑卒中量表(NIHSS)评分。结果 治疗前,两组NIHSS评分和血小板聚集率均无明显差异(P>0.05);治疗后2周,两组NIHSS评分和血小板聚集率均明显改善(P<0.05),而且,联合组明显优于常规组(P<0.05)。结论 阿司匹林与氯吡格雷可以发挥协同作用,进一步降低缺血性脑卒中病人血小板的聚集率,对缺血性脑卒中有更好的疗效。
Abstract:
Objective To investigate the curative effect of aspirin combined with plavix on ischemic stroke and its impact on platelet aggregation rate. Methods The clinical data of 292 patients with ischemic stroke, of whom, 146 patients were treated by routine treatment and aspirin (100 mg, qd; routine group) and 146 patients were treated by plavix (75mg, qd) on the basis of routine and aspirin treatments (combined group) from June, 2014 to June, 2015, were analyzed retrospectively. The platelet aggregation rate was determined and the neurological defect was determined in all the patients by National Institute of Health stroke scale (NIHSS) score before and 2 weeks after the treatment. Results The platelet aggregation rates and NIHSS scores in both the combined and routine groups were significantly lower after the treatment than those before the treatment (P<0.05). The platelet aggregation rates and NIHSS scores were significantly lower in the combined group than those in the routine group 2 weeks after the treatment (P<0.05). Conclusion Aspirin and plavix can play a synergistic role in decrease of the platelet aggregation rate in the patients with ischemic stroke. The curative effect on the patients with ischemic stroke can be enhanced by aspirin combined with plavix.

参考文献/References:

[1] Lei H, Gao Q, Liu SR, et al. The benefit and safety of aspirin for primary prevention of ischemic stroke: a meta-analysis of randomized trials [J]. Front Pharmacol, 2016, 7: 440.
[2] Surendran S, Gilvas V, Sherif AA, et al. Aspirin resistance in acute ischemic stroke and its association with plasma isoprostane levels [J]. J Assoc Physicians India, 2016, 64(1): 63.
[3] 中华医学会神经病学分会中华医学会神经病学分会脑血 管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中 华神经科杂志,2015,48(4):246-257.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑 血管病学组. 中国缺血性脑卒中和短暂性脑缺血发作二 级预防指南2014[J]. 中华神经科杂志,2015,48(4): 258-273.
[5] Gum PA, Kottke-Marchant K, Poggio ED, et al. Profile and prevalence of aspirin resistance in patients with cardiovas- cular disease [J]. Am J Cardiol, 2001, 88(3): 230-235.
[6] Bath PM, Appleton JP, Beridze M, et al. Baseline characte- ristics of the 3096 patients recruited into the ’Triple Anti- platelets for Reducing Dependency after Ischemic Stroke’ trial [J]. Int J Stroke, Epub 2016 Nov 4.
[7] Ozben S, Ozben B, Tanrikulu AM, et al. Aspirin resistance in patients with acute ischemic stroke [J]. J Neurol, 2011, 258(11): 1979-1986.
[8] Sztriha LK, Sas K, Vecsei L. Aspirin resistance in stroke: 2004 [J]. J Neurol Sci, 2005, 229-230: 163-169.
[9] Lev EI, Solodky A, Harel N, et al. Treatment of aspirin- resistant patients with omega-3 fatty acids versus aspirin dose escalation [J]. J Am Coll Cardiol, 2010, 55(2):114-121.
[10] Hankey GJ, Eikelboom JW. Aspirin resistance [J]. Lancet, 2006, 367(9510): 606-617.
[11] Goodman T, Ferro A, Sharma P. Pharmacogenetics of aspirin resistance: a comprehensive systematic review [J]. Br J Clin Pharmacol, 2008, 66(2): 222-232.
[12] 姜梅芳. 补阳还五汤联合阿司匹林治疗短暂性脑缺血发 作时阿司匹林抵抗的临床研究[J]. 中国生化药物杂志, 2014,34(2):116-117.
[13] 孙根义,张 颖,吴 畏,等. 复方丹参滴丸治疗冠心病 阿司匹林抵抗214例临床疗效观察[J]. 世界中医药, 2011,6(4):301-302.
[14] Serebruany VL, Malinin AI, Ziai W, et al. Effects of clopi- dogrel and aspirin in combination versus aspirin alone on platelet activation and major receptor expression in patients after recent ischemic stroke: for the Plavix Use for Treat- ment of Stroke (PLUTO-Stroke) trial [J]. Stroke, 2005, 36(10): 2289-2292.
[15] 王 雯,王维宝,高智玉,等. 阿司匹林联合波立维治疗急 性缺血性脑卒中临床疗效观察[J]. 航空航天医学杂志, 2015,26(5):616-617,628.
[16] Schaefer PW, Pulli B, Copen WA, et al. Combining MRI with NIHSS thresholds to predict outcome in acute ischemic stroke: value for patient selection [J]. Am J Neuroradiol, 2015, 36(2): 259-264.

相似文献/References:

[1]孔令舜 刘玉光.钻孔引流术治疗阿司匹林相关幕上脑出血的效果与安全性[J].中国临床神经外科杂志,2016,(03):181.[doi:10.13798/j.issn.1009-153X.2016.03.019]
[2]唐 铸 桂 铮 李延良 赵建伍 余天垒 张鹏飞 赵立文 于耀宇.药物PAS与支架置入术治疗症状性颈动脉重度狭窄的近期疗效对比分析[J].中国临床神经外科杂志,2015,(12):727.[doi:10.13798/j.issn.1009-153X.2015.12.007]
 TANG Zhu,GUI Zheng,LI Yan-liang,et al.Comparison of clinical effect of intensive therapy with PAS on severe symptomatic carotid artery stenosis with that of carotid artery stenting[J].,2015,(07):727.[doi:10.13798/j.issn.1009-153X.2015.12.007]
[3]宋 平 陈晓斌 杜 浩 蔡 强 罗 明 阮 航 吴京雷 段发亮.内膜斑块剥脱术治疗颈动脉狭窄的临床分析[J].中国临床神经外科杂志,2016,(09):527.[doi:10.13798/j.issn.1009-153X.2016.09.006]
 SONG Ping,CHEN Xiao-bin,DU Hao,et al.Clinical analysis of carotid endarterectomy for ischemic stroke[J].,2016,(07):527.[doi:10.13798/j.issn.1009-153X.2016.09.006]
[4]胡庆雷 陈维杰 张春华 张俊功 徐厚池福.血小板联合血浆治疗长期口服阿司匹林并脑出血的体会[J].中国临床神经外科杂志,2017,(03):195.[doi:10.13798/j.issn.1009-153X.2017.03.027]
[5]汪晓玲 倪志福 王云甫.依达拉奉联合氯吡格雷治疗老年缺血性脑卒中的效果与安全性分析[J].中国临床神经外科杂志,2017,(04):222.[doi:10.13798/j.issn.1009-153X.2017.04.005]
 WANG Xiao-ling,NI Zhi-fu,WANG Yun-fu..Curative effect of edaravone combined with clopidogrel on ischemic stroke and its safety in the elderly patients[J].,2017,(07):222.[doi:10.13798/j.issn.1009-153X.2017.04.005]
[6]王谋龙 李爱红 曲良锁.血清ANP水平及ANP基因多态性与缺血性脑卒中相关性的Meta分析[J].中国临床神经外科杂志,2018,(03):161.[doi:10.13798/j.issn.1009-153X.2018.03.007]
 WANG Mou-long,LI Ai-hong,QU Liang-suo.Meta-analysis of relativity of ANP serum levels and genetic polymorphisms with ischemic stroke risk[J].,2018,(07):161.[doi:10.13798/j.issn.1009-153X.2018.03.007]
[7]颜 博.阿司匹林在不同年龄段脑梗死病人中的二级预防[J].中国临床神经外科杂志,2018,(03):189.[doi:10.13798/j.issn.1009-153X.2018.03.016]
[8]徐东为 赵振伟 李 江 闫忠军 屈 延 高国栋.急性前循环脑动脉闭塞支架成形术的疗效[J].中国临床神经外科杂志,2018,(05):328.[doi:10.13798/j.issn.1009-153X.2018.05.008]
 XU Dong-wei,ZHAO Zhen-wei,LI Jiang,et al.Effect of stenting on acute cerebral artery occlusion in anterior circulation[J].,2018,(07):328.[doi:10.13798/j.issn.1009-153X.2018.05.008]
[9]徐 阳 刘宝辉 袁凡恩 刘骏辉 许鹏飞 陈谦学.小胶质细胞在缺血性脑卒中中作用机制的研究进展[J].中国临床神经外科杂志,2018,(07):503.[doi:10.13798/j.issn.1009-153X.2018.07.020]
[10]秦海林 秦 汉 安学锋 別毕洲.颈动脉内膜斑块剥脱术治疗颈内动脉重度狭窄[J].中国临床神经外科杂志,2018,(12):775.[doi:10.13798/j.issn.1009-153X.2018.12.003]
 QIN Hai-lin,QIN Han,AN Xue-feng,et al.Effect of carotid endarterectomy on patients with severe stenosis of internal carotid artery[J].,2018,(07):775.[doi:10.13798/j.issn.1009-153X.2018.12.003]

更新日期/Last Update: 2017-07-25