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中国实用乡村医生杂志,2017,24(1）·67·论 著不同剂量阿司匹林对脑梗死患者神经功能缺损情况血脂水平和颈动脉内膜厚度的影响王畅 作者单位：515100　广东　汕头，汕头潮南民生医院【摘要】　目的　探讨不同剂量阿司匹林治疗脑梗死患者，对其神经功能缺损情况、血脂水平及颈动脉内膜厚度的影响。方法　选取汕头潮南民生医院2014年8月—2015年6月收治的126例脑梗死患者，随机分为三组各42例。三组分别给予不同剂量的阿司匹林1次/d口服，小剂量组50 mg/次、常规剂量组100 mg/次、大剂量组300 mg/次。观察三组的治疗效果、血脂水平、神经功能、颈动脉内膜厚度及不良反应。结果　小剂量组、常规剂量组及大剂量组治疗总有效率分别为73.81%、69.05%及85.71%，大剂量组总有效率高于其他两组，差异有统计学意义( P ＜0.05)。治疗前三组血脂水平差异无统计学意义( P ＞0.05)；治疗后大剂量组胆固醇、甘油三酯、低密度脂蛋白水平低于其他两组，高密度脂蛋白水平高于其他两组，差异均有统计学意义( P ＜0.05)。治疗前三组神经功能缺损评分、颈动脉内膜厚度及斑块面积差异无统计学意义( P ＞0.05)；治疗后大剂量组神经功能缺损评分、颈动脉内膜厚度及斑块面积均小于其他两组，差异均有统计学意义( P ＜0.05)。不良反应发生率小剂量组4.76%、常规剂量组7.14%、大剂量组9.52%，三组差异无统计学意义( P ＞0.05)。结论　脑梗死患者口服大剂量阿司匹林可提高治疗有效率，调脂作用显著，可有效延缓动脉粥样硬化形成，缩小斑块面积，患者神经功能恢复较好，安全性高，值得临床推广使用。【关键词】　脑梗死；药物治疗；阿司匹林；神经功能缺损；血脂；颈动脉内膜厚度【中图分类号】　R74　【文献标识码】　A【文章编号】　1672-7185 （2017）01-0067-04　doi:10.3969/j.issn.1672-7185.2017.01.027Effect of Aspirin with Different Dosages on the Neural Function Defect, Blood Lipid Levels and Carotid Artery Intima Media Thickness of Patients with Cerebral InfarctionWANG Chang(Shantou Chaonan Minsheng Hospital, Shantou 515100, Guangdong Province, China)【Abstract】  Objective To study the effect of aspirin with different dosages on the neural function defect, blood lipid levels and carotid artery intima media thickness of patients with cerebral infarction. Methods　One hundred and twenty-six patients with cerebral infarction were selected from August 2014 to June 2015 in Shantou Chaonan Minsheng Hospital, and were randomly divided into three groups with 42 patients in each group. Three groups were given different doses of aspirin once per day for oral treatment, with low dose group 50 mg at a time, conventional dose group 100 mg at a time and high dose group 300 mg at a time. The treatment effect, blood lipid level, neural function, carotid intima media thickness and adverse reactions of the three groups were observed. Results　The total effective rate of small dose group, conventional dose group and high dose group were 73.81%, 69.05% and 85.71% respectively. The total effective rate of high dose group was higher than that of the other two groups, and the difference was statistically signif i cant ( P < 0.05). There was no signif i cant difference in blood lipid levels in the three groups before treatment ( P > 0.05). The levels of cholesterol, triglyceride, low-density lipoprotein of the high dose group were lower than that of the other two groups after treatment, and the high density lipoprotein levels were higher than that of the other two groups, the differences were statistically signif i cant ( P < 0.05). The differences of the neural function defect score, the carotid intima media thickness and plaque area between the three groups before treatment were not statistically signif i cant ( P > 0.05). The neural function defect scores, the carotid intima media thickness 万方数据