双嘧达莫联合舒血宁治疗超溶栓时间窗急性脑梗死的临床疗效及凝血指标观察

Clinical Efficacy of Dipyridamole Combined with Shuxuening in the Treatment of Acute Cerebral Infarction with Ultrathrombolytic Time Window

关键词:  双嘧达莫  舒血宁  超溶栓时间窗  急性脑梗死  临床疗效  凝血指标

Key words:  dipyridamole  Shuxuening  ultrathrombolytic time window  acute cerebral infarction  clinical efficacy  coagulation index

摘要:

目的 探讨双嘧达莫联合舒血宁治疗超溶栓时间窗（发病时间>6 h）急性脑梗死的临床疗效及对患者凝血指标的影响。方法 选取2018年1月-2019年1月武汉市武昌医院收治的104例急性脑梗死患者作为研究对象，依据随机对照的方法分为对照组（52例）和观察组（52例）。2组均接受常规治疗，对照组予以舒血宁治疗，观察组予以双嘧达莫联合舒血宁治疗。比较2组临床疗效及不良反应发生率，同时比较2组治疗前后凝血指标[血浆纤维蛋白原（FG）、凝血时间（TT）、活化部分凝血酶原时间（APTT）及凝血酶原时间（PT）]、NIHSS及Fugl-Meyer评分。结果 观察组总有效率为92.31%，显著高于对照组（76.92%），差异具有统计学意义（P=0.03，χ²=4.73）。治疗24 h及48 h后观察组FG水平显著低于对照组，TT、APTT及PT均显著高于对照组（P<0.01）。治疗后观察组NIHSS评分显著低于对照组，Fugl-Meyer评分显著高于对照组（P<0.01）。治疗期间2组均发生心率减慢、恶心呕吐、胃肠出血等不良反应，2组不良反应发生率差异无统计学意义。结论 双嘧达莫联合舒血宁治疗超溶栓时间窗急性脑梗死患者效果优于常规对症治疗，可改善患者血液流变学指标，保护患者神经功能及运动功能，且具有较高的安全性，值得临床推广使用。

Abstract:

OBJECTIVE To investigate the clinical efficacy of dipyridamole combined with Shuxuening in the treatment of acute cerebral infarction with ultrathrombolytic time window(onset time>6 h) and its effect on coagulation index. METHODS From January 2018 to January 2019, according to the method of random control, 104 patients with acute cerebral infarction in Wuhan Wuchang Hospital were divided into control group(52 cases) and observation group(52 cases). Both groups received routine treatment. The control group was treated with Shuxuening, the observation group was treated with dipyridamole combined with Shuxuening. The clinical efficacy and incidence of adverse reactions were compared between the two groups. The coagulation index[FG, TT, APTT amd PT], NIHSS and Fugl-Meyer scores were also compared between the two groups before and after treatment. RESULTS The total effective rate of the observation group was 92.31%, which was significantly higher than that of the control group(76.92%). The difference was statistically significant(P=0.03, χ²=4.73). 24 h and 48 h after treatment, the level of FG in the observation group were significantly lower than those in the control group, the TT, APTT and PT of were significantly higher than those of the control group(P<0.01). After treatment, the score of NIHSS in the observation group was significantly lower than that in the control group. The Fugl-Meyer score was significantly higher than that in the control group(P<0.01). During the treatment, the heart rate slowed down, nausea and vomiting, gastrointestinal hemorrhage and other adverse reactions occurred in both groups, there was no significant difference in the incidence of adverse reactions between the two groups. CONCLUSION The effect of dipyridamole combined with Shuxuening in the treatment of acute cerebral infarction with super thrombolytic time window is better than that of routine therapy. It can improve the hemorheological indexes of patients and protect the neurological and motor functions of patients. And it has high safety and is worth popularizing and using in clinic.