氯吡格雷对急性脑梗死患者血SOD和MDA水平的影响

Effect of clopidogrel on the levels of serum SOD and MDA in patients with acute cerebral infarction

目的探讨氯吡格雷对急性脑梗死患者血清超氧化物歧化酶（sOD）、丙二醛（MDA）水平的影响。方法选择本院2012年1月至2015年1月收治入院的急性脑梗死患者200例，随机分为观察组和对照组两组，每组100例。对照组患者行常规治疗，观察组在常规治疗基础上给予氯吡格雷治疗。两组患者均治疗14d。采用中国卒中量表（CSS）和美国国立卫生研究院卒中量表（NIHSS）对两组患者治疗前、治疗后进行评分，测定患者治疗前、治疗后的血清SOD、MDA、CAT水平。治疗后并对两组患者进行疗效评定。结果观察组的总有效率均明显高于对照组，差异有统计学意义（p〈0．05）；治疗前两组NIHSS评分比较差异无统计学意义（p〉0．05）；第7d、14d时NIHSS评分明显降低，两组比较差异有统计学意义（P〈0．05）；而对照组在用药后第7d、14d评分逐渐下降；观察组患者治疗后血清SOD明显高于治疗前，而MDA水平明显低于治疗前，治疗前后比较差异有统计学意义（P〈0．05）；对照组治疗后血清SOD水平明显低于治疗前，而MDA水平明显高于治疗前，治疗前后比较差异均有统计学意义（P〈0．05）；治疗后血清SOD、MDA水平观察组与对照组比较差异均有统计学意义（P〈0．05）；观察组、对照组均未发生颅内出血事件，监测APTT、PT均在安全范围，血小板计数正常，治疗过程中出现1例轻微消化道出血，给予质子泵抑制剂奥美拉唑保护胃黏膜治疗后痊愈。结论氯吡格雷能够显著抑制急性脑梗死患者脂质过氧化反应，提高抗氧化能力，减轻脑组织氧化损伤，改善患者的神经功能。

Objective To investigate the effect of clopidogrel on the levels of serum superoxide dismutase （SOD） and malondialdehyde （MDA） in patients with acute cerebral infarction. Methods 200 cases of acute cerebral infarction in our hospital from January 2012 to January 2015 were randomly divided into observation group and control group with 100 cases in each group. Control group underwent conventional treatment, while observation group was treated with clopidogrel on the basis of conventional therapy. Two groups were treated for 14 d. Assessed patients of two groups with Chinese Stroke Scale （CSS） and US National Institutes of Health Stroke Scale （NIHSS） before and after treatment. Determined serum SOD, MDA, CAT levels of two groups before and after treatment. And assessed the efficacy of two groups after treatment. Results The total effective rate of observation group was significantly higher than that of control group, with statistically significant difference （P〈0.05）. There was no statistically significant difference in NIHSS score between two groups before treatment （P〉0.05）; NIHSS score significantly decreased at 7 d, 14 d after treatment, there were statistically significant differences between two groups （P〈0.05）. Serum SOD level after treatment in observation group was significantly higher than that before treatment, serum MDA level was significantly lower than that before treatment, with statistically significant differences before and after treatment （P〈0.05）. Serum SOD level after treatment in control group was significantly lower than that before treatment, serum MDA level was significantly higher than that before treatment, with statistically significant differences before and after treatment （P〈0.05）. There were statistically significant differences in serum SOD, MDA levels between two groupsafter treatment （P〈0.05）. There were no intracranial hemorrhage events in observatton group or control group, APTT, PT in the safe range, normal platelet count. 1 case of mild gastrointestinal bleeding occurred during the treatment, cured after administering omeprazole （proton pump inhibitor） to protect gastric mucosa. Conclusion Clopidogrel can significantly inhibit lipid peroxidation in patients with acute cerebral infarction, improve antioxidant capacity, reduce brain tissue oxidative damage, improve neurological function of patients.