| Objective: To retrospectively analyze the clinical features,treatment options and prognosis of acute cerebral infarction in the first people's Hospital of Zhangjiagang from June 2016 to May 2017,and to study the effect of thromboplasty on patients with acute cerebral infarction.Efficacy,prognosis,and safety of antiplatelet therapy with empirical norms.Methods: This study was designed as a retrospective case-control study.C linical data of 299 patients with acute ischemic stroke were collected and analyzed in groups.In the experimental group,the thrombelastography group included 12 aspirin alone(100 mg/d),6 clopidogrel alone(75 mg/d),and aspirin(100 mg/d)plus clopidogrel(75 mg/d)182 cases.The control group was the empirical antithrombotic group,including 11 patients with aspirin alone(100 mg/d),12 patients with clopidogrel alone(75 mg/d),and aspirin(100 mg/d)plus clopidogrel(75 mg/d)76 cases.The modified Rankin scale(mRS)was used to evaluate the self-care ability of the patients at 3 months after discharge from the hospital.The baseline was compared between the experimental group and the control group.The definition of mRS ?2 is divided into good prognosis,mRS3-5 is divided into poor prognosis.The data were compared between different outcomes of acute cerebral infarction patients treated with different antiplatelet regimens,and the incidence of recurrent cerebral infarction,hemorrhage,and death was compared within 3 months.Results: 1?In the control group,there were 12 persons with poor prognosis(12.12% poor prognosis rate),and 200 persons with poor prognosis group(poor prognosis rate 4.50%)in the experimental group.There was a statistically significant difference between the two groups.The risk of poor prognosis in the experimental group Compared with the control group,the risk of mRS increased in the experimental group was lower than that in the control group;in the control group,there were 5 recurrences among the 99 patients(recurrence rate 5.05%),and in the 200 patients in the trial group,there were 7 relapses(recurrence rate 3.50%).There was no statistical difference in the group.2?In the aspirin-sensitive groups,7 in 185 people were poor prognosis(poor prognosis rate 3.78%),and 2 in 9 of insensitive group were poor prognosis(poor prognosis rate 22.22%).After adjusting relevant factors,there was no significant difference between the two groups.There was no statistically significant difference in mRS scores between the two groups;in the sensitive group,there were 7 recurrences in 185(recurrence rate was 3.78%),and 0 in the insensitive group(recurrence rate was 0.00%).There was no statistical difference between the two groups.Meaning(NA).3?In the clopidogrel-sensitive group,5 in 145 people were poor prognosis(poor prognosis rate 3.45%),and 3 in 43 of insensitive groups were poor prognosis(poor prognosis rate 6.98%),after adjustment of relevant factors,the difference between the two groups without statistics In terms of learning significance,there was no significant difference in mRS scores between the two groups.4?The rate of organ bleeding within 90 days in the experimental group was 0%;in the control group,the rate of endophytic organ bleeding was 3.03% at 90 days,including 1.01% of gastrointestinal bleeding,1.01% of bronchial hemoptysis,and 1.01% of infarct hemorrhage.The mortality rate in both the experimental group and the control group was 0% within 90 days;the mortality rate in the control group was 1.01% within six months.Conclusion: 1?The risk of poor prognosis after treatment and the risk of neurologic impairment after antithrombotic therapy guided by the thromboelastography is lower than that of empiric antithrombotic therapy.The recurrence rate and bleeding risk are not significa ntly different.2?After the thrombo-elasticity test for patients who are not sensitive to certain anti-platelet drugs has adjusted anti-platelet protocol,there is no difference between long-term prognosis and sensitive patients. |
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