氯吡格雷治疗进展型缺血性脑卒中的临床研究

Clinical Research on Treatment of Progressive Ischemic Cerebral Apoplexy with Clopidogrel

目的研究氯吡格雷治疗进展型缺血性脑卒中的疗效。方法选取50例发病时间超过24 h,已不适合超早期溶栓治疗的进展型缺血性脑卒中患者,随机分为氯吡格雷组及阿司匹林组,各25例,分别在治疗前和治疗后15 d为患者进行神经功能缺损评分,评定疗效,观察不良反应并进行血流变量监测。结果治疗前,两组患者神经功能缺损评分和实验室各项参数差异均无统计学意义(P>0.05),治疗后两组均较治疗前明显改善,治疗组患者神经功能缺损评分比对照组明显降低(P<0.05),症状改善亦明显优于对照组(P<0.05)。血液流变学改善显著,氯吡格雷组全血黏度和血浆黏度下降程度大于阿司匹林组,无严重不良反应出现。结论进展型缺血性脑卒中患者使用氯吡格雷有效且安全。

Objective To investigate the therapeutic effect of clopidogrel on progressive ischemic cerebral apoplexy. Methods Fifty patients with progressive ischemic cerebral apoplexy beyond 50 hours who were not suitable for super-early thrombolysis therapy were randomly divided into clopidogrel group （25 cases） and positive control-aspirin group （25 cases）. The neurological disability and therapeutic effect were evaluated before and after treatment for 15 days. At the same time, side effects and changes of blood flow were also observed. Results The neurological disability scale and therapeutic effect were obviously improved in the two groups after treatment,but in the clopidogrel group, neurological disability scale and improvement were significantly better than those in the control group （P 〈 0.05）. The blood viscosity and plasma viscosity were significantly decreased in the clopidogrel group. No serious side effects appeared. Conclusion Clopidogrel for the treatment of progressive ischemic cerebral apoplexy is effective and safe.