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临床输血与检验

临床输血与检验 ›› 2017, Vol. 19 ›› Issue (4): 390-393.DOI: 10.3969/j.issn.1671-2587.2017.04.023

• 临床检验 • 上一篇    下一篇

一站式CT对缺血性脑卒中不同方式抗血小板聚集疗效评估*

杨荣伟, 陈自光, 钟仁明, 赵兰锋, 罗传松   

  1. 405200 重庆市梁平区人民医院
  • 收稿日期:2017-01-22 出版日期:2017-08-20 发布日期:2017-08-09
  • 通讯作者: 罗传松（1981-）,男,主要从事缺血性脑卒中研究,（Tel）13668451324（E-mail）376326145@qq.com。
  • 作者简介:杨荣伟（1977-）,男,重庆梁平人,副主任医师,学士,主要从事CT诊断及缺血性脑卒中研究,（Tel）13635301866（E-mail）13635301866@163.com。

Effect of One-stop CT on Antiplatelet Aggregation in Ischemic Stroke

YANG Rong-wei, CHEN Zi-guang, ZHONG Ren-ming, et al   

  1. Radiology Department of Liangping District Hospital of Chongqing City,Chongqing 405200
  • Received:2017-01-22 Online:2017-08-20 Published:2017-08-09

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摘要： 目的 探究一站式CT对缺血性脑卒中不同方式抗血小板聚集的疗效。方法 选取2015年10月~2016年12月于本院接受治疗的急性缺血性脑卒中及超急性缺血性脑卒中患者各96例。按照随机数字表法,将急性缺血性脑卒中患者随机分为A组、B组和C组,将超急性缺血性脑卒中患者随机分为D组、E组和F组,每组32例。A、D两组单用阿司匹林肠溶片100 mg/d,B、E两组单用硫酸氢氯吡格雷片75 mg/d,C、F两组用阿司匹林肠溶片100 mg/d联合硫酸氢氯吡格雷75 mg/d。观察6组患者治疗前后NIHSS评分、mRS评分、ASPECTS评分变化绝对值、梗死区灌注成像参数变化绝对值以及临床疗效。结果 A组、B组治疗前后评分变化绝对值均小于C组,A组治疗前后评分变化绝对值小于D组,B组治疗前后评分变化绝对值小于E组,C组治疗前后评分变化绝对值小于F组,差异有统计学意义（P<0.05）。A组、B组治疗前后梗死区灌注成像参数变化绝对值均小于C组,A组治疗前后梗死区灌注成像参数变化绝对值小于D组,B组治疗前后梗死区灌注成像参数变化绝对值小于E组,C组治疗前后梗死区灌注成像参数变化绝对值小于F组,差异有统计学意义（P<0.05）。C组总有效率96.87%大于A、B两组的84.38%、83.33%,A组总有效率84.38%小于D组的87.50%,B组总有效率83.33%小于E组的84.38%,C组总有效率96.87%小于F组的100.00%,差异有统计学意义（P<0.05）;A、B两组总有效率相似,差异无统计学意义（P>0.05）。结论 治疗前后一站式CT的影像学结果 改变与临床疗效相关,联合治疗使患者血小板聚集率下降最明显,神经功能恢复最好,三种方式治疗超急性脑卒中患者的疗效要优于急性脑卒中患者。

关键词: 一站式CT检查, ASPECTS评分, 缺血性脑卒中, mRS评分

Abstract: Objective To explore the effect of one-stop CT on platelet aggregation in different ways of ischemic stroke. Methods Ninety six patients with acute ischemic stroke （AIS）and hyperacute ischemic stroke（HIS）were treated in the hospital from 2014 to 2016. Patients with AIS were randomly divided into groups A,B and C while those with HIS included groups D,E and F. Both groups A and D were treated with aspirin enteric-coated tablets alone at 100 mg/ day whereas groups B and E were with clopidogrel sulfate at 75 mg/day,and groups C and F were given aspirin at 100 mg/day combined with clopidogrel at 75 mg /day. The absolute value of NIHSS,mRS,and ASPECTS scores were observed pre- and post-treatments,and the absolute value of infusion imaging parameters and clinical efficacy were observed. Results The absolute value of score in groups A and B was significantly lower than that in group C,and the value of group A was significantly lower than that of group D. The absolute value of score in group B was significantly lower than that in group E（P<0.05）. The absolute value of perfusion imaging parameters in groups A and B was significantly lower than that in group C,and the value in group A was significantly lower than that in group D. The infarcted imaging parameters in group B were decreased compered with those in group D whereas the value in group C was lower than that in group F（P<0.05）. The total effective rate of 96.87% in group C was significantly higher than that in groups A （ 84.38%）and B （83.33%）. The total effective rate in group A was 84.38%,significantly smaller than that in group D （87.50%）. The effective rate in group B was 83.33%,which was much lower than that in group E （84.38%）,and the effective rate in group C was 96.87%,smaller than that in group F （100.00%）（P<0.05）. No significant difference was seen between groups A（84.38%）and B（83.33%）（P> 0.05）. Conclusion One-stop CT before and after treatment were related to the clinical efficacy. Combined treatments may obviously decrease platelet aggregation and improve neurological function. The efficacy of the three Methods treatment in patients with hyperacute stroke was better than that of acute stroke patient.

Key words: One-stop CT examination, ASPECTS score, Ischemic stroke, mRS score

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