CAJ | 학술논문

目的：探讨临床氯吡格雷联合拜阿司匹林治疗（双抗治疗）脑梗死并发出血转化（HT ）患者的风险是否增高，以及尽早康复治疗对其预后的影响。方法：收集急性脑梗死患者654例，描述性分析 HT 发生率，观察双抗治疗是否增加 HT发生的风险；在所有发生 HT 的55例患者中选取病情程度及年龄相当的对照组和观察组各15例，观察组患者经康复治疗，比较2组入院前及治疗14d后美国国立卫生研究院卒中量表（NIHSS）、改良的Rankin量表（m RS ）评分。结果：在654例患者中，并发HT的患者共55例（8．41％），双抗的使用并不显著增加HT发生风险。康复治疗后，2组NIHSS评分均较治疗前明显降低（P＜0．05），2组间比较差异无统计学意义。mRS评分比较，观察组较治疗前及对照组治疗后显著降低（P＜0．05），而对照组较治疗前差异无统计学意义。结论：急性脑梗死中HT为急性脑梗死常见并可能影响预后的并发症之一，康复治疗对神经功能的恢复有一定积极意义。
목적：탐토림상록필격뢰연합배아사필림치료（쌍항치료）뇌경사병발출혈전화（HT ）환자적풍험시부증고，이급진조강복치료대기예후적영향。방법：수집급성뇌경사환자654례，묘술성분석 HT 발생솔，관찰쌍항치료시부증가 HT발생적풍험；재소유발생 HT 적55례환자중선취병정정도급년령상당적대조조화관찰조각15례，관찰조환자경강복치료，비교2조입원전급치료14d후미국국립위생연구원졸중량표（NIHSS）、개량적Rankin량표（m RS ）평분。결과：재654례환자중，병발HT적환자공55례（8．41％），쌍항적사용병불현저증가HT발생풍험。강복치료후，2조NIHSS평분균교치료전명현강저（P＜0．05），2조간비교차이무통계학의의。mRS평분비교，관찰조교치료전급대조조치료후현저강저（P＜0．05），이대조조교치료전차이무통계학의의。결론：급성뇌경사중HT위급성뇌경사상견병가능영향예후적병발증지일，강복치료대신경공능적회복유일정적겁의의。
Objective:To study if the combined use of aspirin and clopidogrel increases the risk of hemorrhage transformation (HT) and the prognostic value of early rehabilitation treatment in ischemic stroke patients .Method:654 patients with ischemic stroke were collected to descriptively analyze the rate of HT ,and to observe if the com‐bined use of aspirin and clopidogrel increased the HT risk .Thirty patients were screened in all 55 HT patients and divided into two groups according to the illness degree and age factors :15 not subject to rehabilitation therapy as control group ,and 15 subject to rehabilitation therapy as observation group .The national institute of health stroke scale (NIHSS) and modified Rankin scale (mRS) were compared in two groups before and 14 days after treatment . Results:HT occurred in 55 cases out of 654 patients (8 .41% ) .The combined use of aspirin and clopidogrel could not increase the HT risk .NIHSS scores were significantly decreased in both groups after 14‐day treatment (P<0 .05) without inter‐group differences .The mRS scores were significantly increased after 14‐day rehabilitation thera‐py in observation group as compared with the control group (P<0 .05) .Conclusion:HT is one of common compli‐cations in acute ischemic stroke possibly affecting the prognosis .Rehabilitation therapy can promote the neurological function recovery to some extent .