摘要目的 探讨溶栓前服用抗血小板药对脑梗死（CI）患者的治疗效果及预后。方法 选取我院2017年1月～2019年5月收治的120 例CI 患者作为研究对象，按照溶栓前是否应用抗血小板药分为观察组与对照组各60 例，观察组溶栓前已服用抗血小板药，对照组溶栓前未服用抗血小板药，两组患者均进行溶栓治疗。比较两组治疗后1 d 和治疗后7 d 的疗效、血压、颅内出血及90 d 内的预后情况。结果 观察组治疗后1、7 d 的良好率分别为63.33%、70.00%，高于对照组的40.00%、45.00%，差异均有统计学意义（P＜0.05）；观察组治疗后的血压低于对照组，差异有统计学意义（P＜0.05）；两组90 d 内预后良好率、病死率、颅内出血率比较，差异均无统计学意义（P＞0.05）。结论 溶栓前服用抗血小板药对CI 患者的近期治疗效果较好，能明显改善患者的血压，且不会增加颅内出血的发生率，对患者的预后也不会产生显著影响。
Abstract：Objective To explore the therapeutic effect and prognosis of patients with cerebral infarction (CI) taking antiplatelet drugs before thrombolysis. Methods A total of 120 patients with CI who were admitted to the hospital from January 2017 to May 2019 were selected as the subjects.They were divided into the observation group and the control group according to the use of antiplatelet drugs before thrombolysis，each had 60 cases.Before thrombolysis,the observation group took antiplatelet drugs while the control group did not take.Both groups were treated with thrombolysis therapy.The curative effect at 1 d and 7 d after treatment,blood pressure,intracranial hemorrhage and 90 day prognosis were compared between the two groups. Results The excellent and good rates in the observation group at 1 d and 7 d after treatment (63.33% and 70.00%) were higher than those in the control group (40.00% and 45.00%).The differences were statistically significant (P<0.05).After treatment,the blood pressure of observation group was lower than that of control group,the difference was statistically significant (P<0.05).There were no significant differences in the good rate of 90 day prognosis,mortality rate or rate of intracranial hemorrhage between the two groups (P>0.05).Conclusion The short-term effect of taking antiplatelet drugs before thrombolysis is good in the treatment of patients with CI.It can significantly improve the blood pressure of patients,without increasing the incidence of intracranial hemorrhage or causing obvious influence on the prognosis.
Tsivgoulis G，Katsanos AH，Zand R，et al.Antiplatelet pretreatment and outcomes in intravenous thrombolysis for stroke：a systematic review and metaanalysis[J].J Neurol，2017，264（6）：1227-1235.
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