氯吡格雷对急性脑梗死患者血小板活化和颈动脉硬化斑块的影响

Influence of Clopidogrel on Platelet Activation and Carotid Atherosclerosis Plaque of Acute Cerebral Infraction Patients

目的:探讨氯吡格雷对急性脑梗死患者血小板活化功能和颈动脉硬化斑块的影响。方法:将60例急性脑梗死患者随机分为对照组和氯吡格雷组。两组均予以相同的抗高血压、降颅压、营养脑细胞及对症处理等治疗。对照组和氯吡格雷组分别在此基础上加用阿司匹林肠溶片100mg和氯吡格雷75mg,po,qd,连用6个月。观察治疗前后患者血小板活化功能和颈动脉硬化斑块的变化,并进行临床神经功能缺损评分的评定和不良反应观察。结果:两组患者治疗后血小板活化指标CD62p和CD63水平均明显下降,且氯吡格雷组比对照组下降更明显。氯吡格雷组治疗后斑块大小、厚度和中层内膜厚度(IMT)均明显减小,而对照组治疗前后却无明显变化。两组患者治疗后神经功能缺损评分均明显下降,且氯吡格雷组比对照组下降更明显,治疗其间均无明显不良反应。结论:氯吡格雷治疗急性脑梗死可抑制血小板活化,减少血小板聚集,从而减轻动脉粥样硬化病变,稳定斑块,改善梗死部位缺血缺氧和缺损神经功能,疗效显著、安全性较好。

Objective ： To investigate the effect of clopidogrel on the platelet activation and carotid atherosclerosis plaque of acute cerebral infraction patients. Method ： 60 cases of acute cerebral infarction inpatients were randomly divided into a control group and clopidogrel group clopidogrel. Two groups received the same treatments as anti-hypertension, decreasing intracranial pressure, brain cell nutrition and symptomatic treatment. Except that, The control group received aspirin 100mg, po qd, and the clopidogrel group received clopidogrel 75 mg po qd, for 6 months. The variations of the platelet activation and carotid atherosclerosis plaque were observed before and after the treatment, and their clinic neurologic impairment, assessed Result： 6 months after the treatment, CD62p and CD63, two indexes of platetet activation decreased significantly, and clopidogrel group decreased more significantly than that of the control group. The size and thickness of the plaque and IMT all decreased significantly in clopidogrel group, and there were no differences in the size and thickness of the plaque and IMT in the controlled group before and after the treatment No adverse reactions ware occured, during the therapeutic period of two groups. Conclusion： Clopidogrel can prevent the development of atherosclerosis, make the lesion more stable inhibiting platelet activation and decreasing the thrombocytic of the platelet, and accordingly improve the status of ischemia and anoxia and the function of the defective nerve in the infarction area, and it is obviously effect and safety.