抗栓药物联合治疗急性脑梗死

目的探讨抗栓药物联合应用对失去溶栓机会的急性脑梗死患者的疗效及安全性。方法起病6～12h的急性脑梗死患者约83例，随机分为治疗组和对照组。治疗组（n=46）给与巴曲酶、肠溶阿斯匹林、双嘧达莫等抗拴药物，及其他常规治疗。对照组（n=37）除常规治疗外，尚给与阿斯匹林治疗。观察治疗前及治疗后患者的神经功能缺损评分、Barthel指数，以及治疗组凝血常规等实验指标的变化。结果治疗后14d治疗组神经功能缺损评分（12．7±6．4）显著低于对照组（20．1±7．2）（P〈0．01）。治疗后90天治疗组患者Barthel指数（86．8±12．9），显著高于对照组（43．4±15．1）（P〈0．01）。治疗组总有效率为93．5％，对照组总有效率为56．8％，两组相比差异显著（P〈0．01）。抗栓药物联合治疗后，除纤维蛋白原明显降低外，其他凝血指标没有明显变化。结论抗栓药物联合治疗对失去溶栓机会的急性脑梗死患者较单用阿司匹林有更好的临床效果，而且出血事件的风险也没有增加。

Combinative antithrombotic therapy for patients with acute cerebral infarction

Objective To investigate the efficacy and safety of combinative antithrombotic therapy for patients with acute cerebral infarction who were not eligible for thrombolysis. Methods Eighty-three patients with acute cerebral infarction at six to twelve hours after the onset were randomly allocated into two groups : treat-ment group(n=46) recived batroxobin, aspirin and dipyridamole; control group(n=37) received aspirin. Neuro-logic impairment scole was measured at days 0, and 14. Barthel index of the two groups were observed at days 0 and 90. Blood coagulation action of the treatment group was also measured at days 0,5 and 11. Results In treatment group, the nervous function defect integral examined 14 d after trearment (12.7±6.4 )was markedly decreased than that of control group (20.1±7.2). A remarkable difference (P<0.01 ) was noticed between them. The Barthel index of the treatment group at 90 d after trearment (86.8±12.9 )was markedly increased than that of control group(43.4±15.1 ) (P<0.01 ). The total effective rate of treatment group and control group were 93.5% and 56.8% respectively( P<0.01). Conclusion The efficacy of combinative antithrombotic therapy for patients with acute cerebral infarction who were not eligible for thrombolysis is better than aspirin a-lone. Further more, the risk of bleeding may not increase in combinative antithrombotic therapy.