目的 觀察氯吡格雷聯(lián)合阿司匹林治療急性腦梗死的臨床效果。方法 納入2017年8月-2019年5月在沈陽(yáng)醫(yī)學(xué)院附屬第二醫(yī)院就診的急性腦梗死患者180例，隨機(jī)分為對(duì)照組（90例）和治療組（90例）。對(duì)照組口服阿司匹林腸溶片，300 mg/d，治療14 d后100 mg序貫治療。治療組在對(duì)照組的基礎(chǔ)上口服硫酸氫氯吡格雷片，300 mg/d，次日改為75 mg/d，治療14 d后，改為阿司匹林100 mg序貫治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生院神經(jīng)功能缺損評(píng)分（NIHSS）和出院6個(gè)月后RANKIN量表（mRS）評(píng)分。結(jié)果 治療后，對(duì)照組臨床有效率為78.89%，顯著低于治療組的91.11%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者NIHSS評(píng)分明顯下降（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。出院6個(gè)月后，兩組患者M(jìn)RS評(píng)分明顯降低（P<0.05），且治療組降低更明顯（P<0.05）。結(jié)論 氯吡格雷聯(lián)合阿司匹林治療急性腦梗死臨床治療效果顯著，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the effect of clopidogrel combined with aspirin in treatment of mild to moderate acute cerebral infarction. Methods Patients (180 cases) with mild to moderate acute cerebral infarction in the Second Affiliated Hospital of Shenyang Medical College from August 2017 to May 2019 were randomly divided into control (90 cases) and treatment (90 cases) groups. Patients in the control group were po administered with Aspirin Enteric-coated Tablets, 300 mg/d, then administered sequential therapy with 100 mg after 14 d. Patients in the treatment group were po administered with Clopidogrel Hydrogen Sulphate Tablets on the basis of the control group, 300 mg/d, and 75 mg/d for the second day, then administered sequential therapy with 100 mg Aspirin Enteric-coated Tablets after 14 d. After treatment, the clinical efficacy was evaluated, the NIHSS scores and mRS scores 6 months after discharge in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 78.89%, which was significantly lower than 91.11% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After discharge 6 months, the mRS scores in two groups were significantly decreased (P<0.05), and the scores in the treatment group were significantly lower than that in the control group (P<0.05). Conclusion Clopidogrel combined with aspirin is effective in treatment of mild to moderate acute cerebral infarction, which has a certain clinical application value.

R971

沈陽(yáng)市科技計(jì)劃項(xiàng)目（18-014-4-99）；沈陽(yáng)醫(yī)學(xué)院科技基金項(xiàng)目（20172034）