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  [摘要] 目的：观察氯吡格雷联合低分子肝素钠治疗进展性缺血性脑卒中的疗效。方法：选择135例发病在12～48 h，病情呈进行性加重的进展性缺血性脑卒中患者，随机分为三组，分别接受低分子肝素钠治疗、氯吡格雷治疗、氯吡格雷和低分子肝素钠联合治疗。1个疗程后进行疗效判定，并监测治疗前后血液流变学的变化。结果：1个疗程后低分子肝素钠组总有效率为82.2%、联合用药组总有效率为93.3%，均明显高于氯吡格雷组的73.3%，而且治疗前后血液流变学的变化亦有显著性差异，联合用药组总有效率最高和血流变学变化最明显，同时未发现出血倾向等不良反应。结论：低分子肝素能有效治疗进展性缺血性脑卒中，与氯吡格雷联合使用具有协同作用，临床疗效确切、安全。

 [关键词] 氯吡格雷；低分子肝素钠；缺血性脑卒中；联合

 [中图分类号] R743.33[文献标识码]C [文章编号]1673-7210(2009)05(a)-087-02

 The observation of curative effect of Clopidogrel hydrogen sulfate combined with Low molecular heparin in treating progressive cerebral arterial thrombosis

 WU Yong, LIANG Yan, HUANG Dandan, LU Changsheng

 (The People's hospital of Gaozhou county, Guangdong Province, Gaozhou 525200, China)

 [Abstract] Objective: To observe the curative effect of Clopidogrel hydrogen sulfate combined with Low molecular heparin in treatingprogressivecerebral arterial thrombosis. Methods: We selected 135 cases of progressive cerebral arterial thrombosis happened from 12 hours to 48 hours, and distributed into 3 groups randomly. We used Low molecular heparin、Clopidogrel hydrogen sulfate、Clopidogrel hydrogen sulfate combined with Low molecular heparin separately to treate it.Results: After one course of treatment, total effective rate of Low molecular heparin and Clopidogrel hydrogen sulfate combined with Low molecular heparin were 82.2% and 93.3% separately, much higher than total effective rate of Clopidogrel hydrogen sulfate(73.3%). The change of the blood hemorrheology before and after treatment was determined. In the group of treating with Clopidogrel hydrogen sulfate combined with Low molecular heparin we had the higher total effective rate and much evident change of the blood hemorrheology than the other groups, and the adverse effect hemorrhagic tendency didn't found. Conclusion: Low molecular heparin has effective therapy on progressive cerebral arterial thrombosis, while Clopidogrel hydrogen sulfate combined with Low molecular heparin has the synergistic effect, and the clinic therapeutic effect is identify and safety ......