摘要
目的探讨静脉溶栓后抗血小板药物给药时机对急性缺血性脑卒中患者近期预后及神经功能的影响。方法选取2017年7月至2021年8月本院收治的118例急性缺血性脑卒中患者作为研究对象,依据给药时机不同分为甲组(溶栓治疗后>24 h给予抗血小板药物,n=59)与乙组(溶栓治疗后<24 h给予抗血小板药物,n=59)。两组均开展静脉溶栓治疗,甲组于溶栓24 h后给予阿司匹林联合氯吡格雷治疗,乙组于溶栓后24 h内给予阿司匹林联合氯吡格雷治疗,比较两组不良事件发生率、神经功能[美国国立卫生研究院卒中量表(NIHSS)]、认知功能[简易精神状态评价量表(MMSE)]及凝血指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)]。结果两组不良事件发生率比较差异无统计学意义。治疗前、治疗3个月后,两组NIHSS评分比较差异无统计学意义;治疗3个月后,两组NIHSS评分均低于治疗前,差异有统计学意义(P<0.05)。两组瞬时记忆、定向力、视觉及空间觉、注意力计算力评分比较差异无统计学意义。甲组APTT、PT、TT均短于乙组,差异有统计学意义(P<0.05)。结论静脉溶栓24 h内或静脉溶栓24 h后开展抗血小板治疗对患者不良事件、神经功能、认知功能方面的影响不明显,但静脉溶栓24 h后开展抗血小板治疗,可降低患者凝血功能指标。
Objective To investigate the effect of timing of administration of antiplatelet drugs after intravenous thrombolysis on short-term prognosis and neurological function in patients with acute ischemic stroke.Methods 118 patients with acute ischemic stroke admitted to our hospital from July 2017 to August 2021 were selected as the research subjects,and they were divided into the group A according to the timing of administration(antiplatelet drugs were given>24 h after thrombolytic therapy,n=59)and the group B(antiplatelet drugs were given<24 h after thrombolytic therapy,n=59).Both groups were treated with intravenous thrombolytic therapy,Group A was given aspirin combined with clopidogrel 24 h after thrombolytic therapy,group B was given aspirin combined with clopidogrel within 24 h after thrombolytic therapy,the incidence of adverse events,neurological function(National Institute of Health stroke scale[NIHSS]),cognitive function(mini-mental state examination[MMSE])and coagulation parameters(activated partial thromboplastin time[APTT],prothrombin time[PT],thrombin time[TT])were compared between the two groups.Results There was no statistically significant difference in the incidence of adverse events between the two groups.Before treatment and after 3 months of treatment,there was no significant difference in NIHSS scores between the two groups;after 3 months of treatment,the NIHSS scores of two groups was lower than that before treatment,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the scores of instantaneous memory,orientation,visual and spatial perception,and attention and computation between the two groups.The APTT,PT,and TT in the group A were shorter than those in the group B,and the differences were statistically significant(P<0.05).Conclusion Antiplatelet therapy within 24 h of intravenous thrombolysis or 24 h after intravenous thrombolysis has no significant effect on adverse events,neurological function,and cognitive function of patients,bu
作者
刘秋怡
龙贵华
周玉静
LIU Qiuyi;LONG Guihua;ZHOU Yujing(Department of Neurology,the Third Affiliated Hospital of Guangdong Medical University/Longjiang Hospital,Shunde District,Foshan City,Foshan,Guangdong,528000,China;ICU,the Third Affiliated Hospital of Guangdong Medical University/Longjiang Hospital,Shunde District,Foshan City,Foshan,Guangdong,528000,China)
出处
《当代医学》
2023年第13期111-114,共4页
Contemporary Medicine
关键词
静脉溶栓
抗血小板药物
给药时机
急性缺血性脑卒中
Intravenous thrombolysis
Antiplatelet drugs
Timing of administration
Acute ischemic stroke
