Application value of thromboelastography in the antithrombotic treatment of acute atherosclerotic cerebral infarction
HAO Fangfang1 MU Bin1 MENG Xiang′an2 ZHANG Yingjie1 FAN Qingyi1 WU Baoshui1
1.Department of Neurology, Hebei Petro China Central Hospital, Hebei Province, Langfang 065000, China;
2.Department of Ultrasound Medicine, Hebei Petro China Central Hospital, Hebei Province, Langfang 065000, China
Abstract：Objective To investigate the value of thromboelasto graph (TEG) in antithrombotic therapy for acute atherosclerotic cerebral infarction (CI). Methods A total of 160 patients with acute atherosclerotic CI admitted to Hebei Petro China Central Hospital from December 2017 to July 2019 were selected as the study subjects, according to random number table method, they were divided into the Aspirin group (n = 40, Aspirin antithrombotic therapy), Clopidogrel Bisulfate group (n = 40, Clopidogrel Bisulfate Antithrombotic therapy), the joint group (n = 40, Aspirin combine with Clopidogrel Bisulfate antithrombotic therapy), TEG guide group (n = 40, based on the guidance of TEG antithrombotic therapy, high platelet inhibition rate of antithrombotic drug treatment individualized programs was chosen). Clinical efficacy, microembolus (MES) monitoring, daily life ability and neurological function impairment, adverse reactions, bleeding events and recurrence were compared in each group. Results After treatment, the total clinical response rate of the combined group and the TEG guide group were higher than those of the Aspirin group and Clopidogrel Bisulfate group (P ＜ 0.05). After treatment, the MES positive rate in all four groups were lower than those before treatment (P ＜ 0.05), and the MES positive rate in both the combined group and the TEG guide group were lower than those in the Aspirin group and Clopidogrel Bisulfate group (P ＜ 0.05). After treatment, the improved Barthel index scores of the four groups were higher than those before treatment, and the NIHSS scores were lower than those before treatment (P ＜ 0.05), the improved Barthel index score of the combined group and the TEG guide group were all higher than those of the Aspirin group and Clopidogrel Sulfate group (P ＜ 0.05), the NIHSS scores were lower than those of Aspirin group and Clopidogrel Bisulfate group (P ＜ 0.05). The incidence of bleeding events in Clopidogrel Bisulfate group and TEG guide group were lower than those in the combined group (P ＜ 0.05). After treatment, the recurrence rates of the combined group and the TEG guide group were all lower than those of the Aspirin group and Clopidogrel Bisulfate group (P ＜ 0.05). Conclusion In the antithrombotic therapy of acute atherosclerosis CI patients, TEG-guided individualized therapy has better clinical effect and higher safety than Aspirin and Clopidogrel Bisulfate alone.
2020, Vol. 17 
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