目的 研究曲克蘆丁聯(lián)合雙重抗血小板治療對腦梗死患者臨床療效、凝血功能和神經(jīng)功能的影響。方法 選擇2016年1月—2018年12月河南省洛陽市第三人民醫(yī)院神經(jīng)內科的84例腦梗死患者，用抽簽法隨機分為對照組和觀察組，每組各42例。對照組采用雙重抗血小板治療，口服硫酸氫氯吡格雷片75 mg/d和阿司匹林腸溶片100 mg/d。觀察組在對照組治療的基礎上聯(lián)合曲克蘆丁片，1片/d。兩組均治療14 d。觀察兩組患者的臨床療效，同時比較兩組患者凝血功能和神經(jīng)功能指標。結果 治療后，觀察組治療的總有效率為90.48%，明顯高于對照組的76.19%（P<0.05）。兩組治療后的纖維蛋白原、血小板計數(shù)和二聚體均明顯降低（P<0.05），且觀察組凝血功能指標水平均明顯低于對照組（P<0.05）。兩組治療后的NIHSS評分和改良Rankin評分均明顯降低（P<0.05）；且觀察組NIHSS評分和改良Rankin評分明顯低于對照組（P<0.05）。兩組治療后的神經(jīng)元特異性烯醇化酶（NSE）水平明顯降低，神經(jīng)營養(yǎng)因子（NTF）和神經(jīng)生長因子（NGF）水平均明顯升高（P<0.05）；且觀察組神經(jīng)細胞因子水平明顯優(yōu)于對照組（P<0.05）。結論 曲克蘆丁聯(lián)合雙重抗血小板方案治療能改善腦梗死患者的凝血功能和神經(jīng)功能，促進功能恢復，且安全性較好，具有臨床推廣應用價值。

Objective To study the effect of troxerutin combined with dual antiplatelet regimens on clinical efficacy, blood coagulation and neurological function in patients with cerebral infarction. Methods 84 cases of patients with cerebral infarction who were treated in Luoyang Third People's Hospital from January 2016 to December 2018 werer divided into control and observation groups randomly, and each group had 42 cases. Patients in the control group were given dual antiplatelet regimens, po administered with Clopidogrel Hydrogen Sulphate Tablets 75 mg/d, and Aspirin Enteric-coated Tablets 100 mg/d. Patients in the observation group were po administered with Troxerutin Tablets on the basis of control group, 1 tablet daily. Patients in two groups were treated for 14 d. The clinical efficacy of the two groups was observed, and the indicators of coagulation function and nerve function were compared between two groups. Results After treatment, the total effective rate of the observation group was 90.48%, which was significantly higher than 76.19% of the control group (P<0.05). After treatment, fibrinogen, platelet count and dimer in two groups were significantly decreased (P<0.05), and coagulation function indexes in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NIHSS score and modified Rankin score were significantly reduced after treatment in two groups (P<0.05). And NIHSS score and modified Rankin score in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NSE level in two groups were decreased, but the levels of NTF and NGF were significantly increased (P<0.05), and nerve cytokine levels in the observation group were significantly better than those in the control group (P<0.05). Conclusion Troxrutin combined with dual anti-platelet therapy can improve the coagulation and nerve functions of patients with cerebral infarction, promote functional recovery, and is safe, with clinical application value.

R971

河南省科技發(fā)展項目（0624410102）