氯吡格雷对缺血性脑卒中患者血清基质金属蛋白酶-9及其抑制剂-1的影响

The effect of clopidogrel on serum matrix metalloproteinase-9 and its inhibitor-1 in patients with ischemic stroke

目的探讨氯吡格雷对缺血性脑卒中患者血清基质金属蛋白酶-9(MMP-9)及其抑制剂-1(TIMP-1)的影响。方法选择74例缺血性脑卒中患者分为观察组和对照组,常规予以控制颅内压、血压和血糖以及营养脑细胞等基础治疗。观察组在此基础上加用氯吡格雷75 mg,1次/d;对照组加用拜阿司匹林肠溶片100mg,1次/d,两组均连用2周。结果治疗2周后,两组患者的血浆MMP-9水平较前明显下降,血浆TIMP-1水平较前明显上升(P<0.05或P<0.01),且观察组下降或上升幅度较对照组更明显(P<0.05);同时治疗2周后,观察组的临床疗效明显优于对照组(χ2=4.57,P<0.05)。两组治疗期间均无严重的药物不良反应。结论氯吡格雷治疗缺血性脑卒中的疗效确切,安全性较好,作用与其降低血浆MMP-9和TIMP-1的比值失调密切相关。

Objective To investigate the effect of clopidogrel on serum matrix metalloproteinase-9 and its inhibitor-1 in patients with ischemic stroke Methods A total of 74 cases of ischemie stroke patients were divided into observation group and control group. Both groups were routinely given the basic treatment of control｜ing intracranial pressure, blood pressure and blood glucose as well as nourishing brain cells. Observation group were given clopidogrel 75rag, once daily on this basis, while control group were given Aspirin enteric-coated tablets 100 mg, once daily on this ba- sis. And both groups were treated for 2 weeks. Results After two weeks of treatment, plasma MMP-9 levels were sig- nificantly decreased and plasma TIMP-1 levels were increased significantly in the two groups of patients（P 〈0. 05） or （P 〈0.01）. And the amplitudes of decrease or increase of the observation group were more significant than those in the control group（P 〈0. 05）. The clinical efficacy of the observation group was significantly better than that in the control group （X2=4.57, P 〈0. 05） After two weeks of treatment. There were no severe adverse drug reactions during treatment in both groups. Conclusion Clopidogrel has the exact efficacy in the treatment of isehemic stroke with better security, and the role is closely related to its function of lowering plasma MMP-9 and TIMP-1 ratio imbalance.