关键词: 急性脑梗死; 阿司匹林; 阿托伐他汀钙; 血栓弹力图; C反应蛋白

Abstract:

Objective To study the first week after acute cerebral infarction using large-dose bayaspirin combined the clinical curative effect of atorvastatin calcium tablet, and to observe thrombus elastic graph (thrombelastogram, TEG) and c-reactive protein (CRP) level changes. Methods The randomized grouping was used to divide the patients with acute cerebral infarction in the department of neurology of Liaocheng City Central Hospital into two groups, namely, 60 cases in the large-dose group and 60 cases in the control group. The large dose group was given aspirin tablets of 300 mg of aspirin tablets and a total of 40 mg oral (international guidelines), 1time/d, lasting 7 days. After that, it was replaced with aspirin tablets 100 mg and combined with atorvastatin calcium tablets 20 mg, 1 time/d, lasting 7 days. The control group was treated with aspirin tablets 100 mg and combined with atorvastatin calcium 20 mg, 1 time/d, lasting 14 days. At the same time, both groups were given basic treatment and appropriate symptomatic treatment. All patients received the National Institutes of Health Stroke Scale (NIHSS) score, TEG and CRP detection before and after treatment of 14 d. The modified Rankin Scale (mRS) score at admission and at Month 3 follow up were evaluated to assess the influence of the two treatment options for patients with recovery and to assess recurrence rate of ischemic events in each group. Results (1) After treatment of 14 d, the NIHSS score of the large dose group was significantly lower than that in the control group (P <0.05), and the difference was statistically significant; the two groups were significantly reduced compared with the previous NIHSS scores before treatment (P <0.05), and the difference was statistically significant. (2) After treatment of 14 d, the coagulation reaction time, (reaction time, R) and haemagglutination block forming time (kinetics of clot development, K) were greater than that before the treatment, while haemagglutination block formation rate (alpha) and maximum intensity of blood clots (MA) were less than before treatment (P <0.05), which had significant statistical differences. After treatment of 14 d, the large dose group and the control group were compared: TEG was close to each other (P >0.05), which had no statistical significance. (3) The CRP level of both groups after treatment of 14 d was significantly lower than that in the treatment group before treatment (P <0.05), and the difference was statistically significant. After treatment of 14 d, the reduction of CRP in the large-dose group was significantly lower than that in the control group, which had significant statistical difference (P <0.01). (4) The mRS score of the two groups before and after treatment was compared and had significant difference (P <0.05). Compared with the treatment after 14 d, the difference of mRS in large dose group and control group had significant difference (P <0.05). (5) After 3 months follow-up, 2 cases in the large-dose group had a recurrence of ischemic events, and the proportion was 3.33%; and the control group had 5 patients with ischemic events, which was 8.33%. The difference between two groups was statistically significant (P <0.05). Conclusion The treatment of patients with acute cerebral infarction in the first week of the treatment of aspirin 300 mg combined with atorvastatin calcium 40 mg was better than that of conventional small doses and was worthwhile for the clinical application.

Key words: Acute cerebral infarction; Aspirin; Atorvastatin calcium; Thrombus elastic figure; C-reactive protein