中文摘要：

目的分析双联抗血小板治疗后循环缺血性脑卒中的临床疗效及对预后影响。方法选择2014年3月—2016年3月郑州大学第二附属医院收治的124例后循环缺血性脑卒中患者进行研究,按随机数字法分为对照组（n=62,阿司匹林）和观察组（n=62,阿司匹林与氯吡格雷）,连续治疗2周后,观察并比较患者的临床疗效、凝血指标的变化以及于患者出院后随访1年的预后和不良反应的发生情况。结果治疗后,两组患者的NIHSS评分、ADAS-Cog评分与治疗前相比均有所降低,但观察组的NIHSS评分、ADAS-Cog评分均显著低于对照组,（P〈0.05）。治疗后,观察组的PT和APTT水平均显著高于对照组,但FIB水平显著低于对照组,（P〈0.05）。观察组治疗后的总不良反应发生率与对照组无明显差别,差异具无统计学意义（P〉0.05）。随访一年后,观察组的复发率、致残率及死亡率略低于对照组,差异无统计学意义（P〉0.05）。结论采用双联抗血小板治疗后循环缺血性脑卒中,有利于改善患者临床疗效及预后,不良反应小,安全性良好,推荐临床使用。

英文摘要：

Objective To analyze the clinical efficacy and prognostic value of dual antiplatelet therapy in patients with posterior circulation ischemic stroke. Methods A total of 124 patients with posterior circulation ischemic stroke in our hospital from March 2014 to March 2016 were randomly selected and divided into the control group（ n = 62,aspirin） and the observation group（ n = 62,Clopidogrel and aspirin）. After 2 weeks of continuous treatment,the changes of coagulation parameters,clinical efficacy,adverse reaction conditions and prognosis after 1 years of follow-up were observed and compared between the two groups. Results After treatment,patients with NIHSS score and ADAS-Cog score in the two groups were significantly decreased as comparing with that before treatment,but NIHSS score and ADAS-Cog score of the observation group were significantly lower than that of the control group（ P〈0. 05）. The levels of PT and APTT in the observation group after treatment were significantly higher than that in control group,while the level of FIB was significantly lower than that of the control group（ P〈0. 05）. The total incidence of adverse reaction showed no significant difference between the observation group and control group（ P〉0. 05）. After 1 years of follow-up,the recurrence rate,the disability rate and mortality rate of the observation group were little lower than that of the control group,there were no statistical differences（ P〈0. 05）. Conclusion The use of dual antiplatelet therapy in the treatment of posterior circulation ischemic stroke was helpful to improve the clinical efficacy,have good prognosis and high safety,which is worthy of clinical application.