摘要
目的探讨银杏二萜内酯葡胺注射液(Diterpene Ginkgolides Meglumine Injection,DGMI)联合双重抗血小板(双抗)治疗急性非心源性轻型卒中的疗效。方法将355例急性缺血性卒中患者分为双抗组和联合用药组,双抗组采用阿司匹林联合氯吡格雷治疗,联合用药组采用DGMI联合双抗治疗。比较2组治疗前后的美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分和改良Rankin量表(modified Rankin Scale,mRS)评分;比较2组30 d、90 d、6个月卒中复发情况与出血情况,并对卒中复发因素进行多因素分析。结果治疗前2组基本资料比较差异无统计学意义。治疗14 d后,2组的NIHSS评分和mRS评分均下降,且联合用药组低于双抗组(P<0.05)。联合用药组90 d和6个月卒中复发率低于双抗组(P值分别为0.023、0.003)。联合用药未增加出血风险,且2组出血风险比较差异无统计学意义。多因素Logistic回归分析显示,DGMI是降低急性非心源性轻型卒中90 d(OR=0.233,95%CI为0.059~0.910,P=0.036)和6个月(OR=0.459,95%CI为0.253~0.834,P=0.011)卒中复发的独立保护性因素。结论DGMI联合双抗治疗急性非心源性轻型卒中可显著改善患者的神经功能、降低卒中复发风险,且不会增加出血风险及不良事件发生率。
Objective To explore the effect of Diterpene Ginkgolides Meglumine Injections(DGMI)combined with double antiplatelet therapy in patients with acute non-cardiogenic minor stroke.Methods A total of 355 eligible patients with acute ischemic stroke were included and divided into double antiplatelet therapy group and combination medication group.The double antiplatelet therapy group was given aspirin combined with clopidogrel therapy,and the combination medication group was given DGMI combined with double antiplatelet therapy.The National Institutes of Health Stroke Scale(NIHSS)score and modified Rankin Scale(mRS)score were compared between the 2 groups before and after treatment.The stroke recurrence events and bleeding at the 30th day,90th day,and 6th month after treatment in both groups were recorded,and multivariate analysis was performed on the recurrence factors of stroke.Results There was no significant difference in baseline characteristics between the 2 groups before treatment.Compared with before treatment,the NIHSS score and mRS score of the 2 groups after 14 days of treatment were decreased,and those of the combined treatment group were lower than those of the double antiplatelet therapy group.The recurrence rate of stroke at the 90th days and 6th months in the combination medication group was lower than that in the double antiplatelet therapy group(P=0.023,0.003,respectively).The combined medication group did not increase bleeding risks,and there was no significant difference in the bleeding risks between the 2 groups.Multivariate logistic regression analysis showed that DGMI was an independent protective factor for stroke recurrence at the 90th day(OR=0.233,95%CI 0.059-0.910,P=0.036)and the 6th month(OR=0.459,95%CI 0.253-0.834,P=0.011)in patients with acute non-cardiogenic minor stroke.Conclusion DGMI combined with Double antiplatelet therapy in the treatment of acute non-cardiogenic minor stroke can significantly improve neurological function,reduce the risks of stroke recurrence,and does not increase t
作者
马文阳
汤武装
孙杨
李杰
MA Wenyang;TANG Wuzhuang;SUN Yang;LI Jie(Department of Neurology,Yixing Hospital Affiliated to Jiangsu University,Yixing 214200,China;Department of Neurology,Wuxi Second People’s Hospital,Wuxi 214001,China)
出处
《西北药学杂志》
CAS
2023年第5期149-154,共6页
Northwest Pharmaceutical Journal
基金
江苏省卫健委指导性项目(编号:Z2021001)
无锡市(宜兴市)“双百”中青年医疗卫生拔尖人才项目(编号:BJ2020108)
无锡市卫健委面上项目(编号:M202157)。
