依达拉奉联合氯吡格雷治疗老年缺血性脑卒中的效果与安全性分析

Curative effect of edaravone combined with clopidogrel on ischemic stroke and its safety in the elderly patients

目的探讨依达拉奉联合氯吡格雷治疗老年缺血性脑卒中的效果与安全性。方法 2014年1月到2016年5月前瞻性收治老年缺血性脑卒中160例,按随机信封抽签原则分为观察组与对照组,各80例;对照组给予口服氯吡格雷治疗,观察组在对照组治疗的基础上加用依达拉奉注射液治疗。结果治疗2周后,观察组总有效率(93.8%)明显高于对照组(75.0%;P<0.05)。治疗2周后,两组血清白介素-6(IL-6)和肿瘤坏死因子~α(TNF-α)水平均明显低于治疗前(P<0.05),而且,观察组血清IL-6和TNF-α水平均明显低于对照组(P<0.05)。治疗2周后,观察组与对照组的生存质量评分为都明显高于治疗前(P<0.05),且观察组明显高于对照组(P<0.05)。治疗后90 d,观察组症状性脑出血发生率(0%)与非症状性脑出血发生率(1.3%)均明显少于对照组(分别为12.5%和12.5%;P<0.05)。结论依达拉奉联合氯吡格雷治疗老年缺血性脑卒中能提高疗效,其机制可能与抑制机体炎症因子的表达有关。

Objective To investigate the curative effect of edaravone combined with clopidogrel on ischemic stroke and its safety in elderly patients. Methods One hundred and sixty elderly patients with ischemic stroke treated in our hospital from January, 2014 to May, 2016 were randomly divided into two groups, i.e. control group in which the patients （n=80） were treated by clopidogrel after the thrombolysis and observed group in which the patients were treated by edaravone combined with clopidogrel after thrombolysis. The serum levels of IL-6 and tumor necrosis factor α （TNF-α） were determined in all the patients before and 2 weeks after the treatment. The prognoses and safety were compared between both the groups. Results The effective rate （93.8%） was significantly higher in the observed group than that （75.0%） in the control group （P〈0.05）. The serum levels of IL-6 and TNF-α were significantly lower after the treatment than those before the treatment in the two groups （P〈0.05）, and the serum levels of IL-6 and TNF-α in the observed group were significantly lower than those in the control group after the treatment （P〈0.05）. The life quality scores were significantly higher after the treatment than those before the treatment in the observed and the control groups （P〈0.05）. The life quality scores were significantly higher in the observed group than those in the control group after the treatment （P〈0.05）. The incidence of symptomatic cerebral hemorrhage and non symptomatic cerebral hemorrhage were significantly lower in the observed group than those in the control group after the treatment （P〈0.05）. Conclusions That the curative effect and life quality can be improved and the complications can be decreased by the application of edaravone combined with clopidogrel in the elderly patients with ischemic stroke may be related to the inhibition of serum inflammatory factors expressions including IL-6 and TNF-α.