硫酸氢氯吡格雷联合阿司匹林肠溶片治疗脑梗死的疗效及对血清高敏C反应蛋白、血脂、颈总动脉内膜中层厚度的影响

Efficacy of clopidogrel sulfate combined with aspirin enteric-coated tablet in treatment of cerebral infarction and its effect on serum high-sensitivity C-reactive protein,blood lipid and intima-media thickness of common carotid artery

目的探讨硫酸氢氯吡格雷联合阿司匹林肠溶片治疗脑梗死的疗效及对血清高敏C反应蛋白(hs-CRP)、血脂、颈总动脉内膜中层厚度(IMT)的影响。方法将88例脑梗死患者随机分为观察组与对照组,每组44例。对照组在常规治疗的基础上给予口服阿司匹林肠溶片,观察组在对照组的基础上加用口服硫酸氢氯吡格雷,两组疗程均为2周。比较两组患者疗效及治疗前后血清hs-CRP、TC、TG、HDL-C、LDL-C及颈总动脉IMT。结果治疗前两组患者的血清hs-CRP、TC、TG、HDL-C、LDL-C及颈总动脉IMT水平比较,差异无统计学意义(P>0.05);治疗后两组患者的血清hs-CRP、TG、TC、LDL-C及颈总动脉IMT水平较治疗前均下降,HDL-C较治疗前均上升,且观察组各项指标改善均优于对照组(P<0.05);观察组治疗总有效率为90.9%(40/44),优于对照组的52.3%(23/44)(P<0.05)。结论硫酸氢氯吡格雷联合阿司匹林肠溶片治疗脑梗死疗效确切,能有效改善患者的血清hs-CRP与血脂指标,减少颈总动脉内膜中层厚度,值得临床推广。

Objective To investigate the efficacy of clopidogrel sulfate combined with aspirin enteric-coated tablet in the treatment of cerebral infarction and its effect on serum high-sensitivity C-reactive protein（hs-CRP） ,blood lipid and intima-media thickness（IMT） of common carotid artery. Methods Eighty-eight patients with cerebral infarction were randomly divided into observation group and control group, and each group contained 44 cases. The control group was given conventional therapy and oral aspirin enteric-coated tablet, while the observation group was treated with oral clopidogrel sulfate based on the therapy performed in the control group. The treatment lasted for 2 weeks in the two groups. The curative effect, and the levels of serum hs-CRP, TC ,TG, HDL-C, LDL-C and common carotid artery IMT before and after treatment were compared between the two groups. Results Before treatment, there was no significant difference in serum level of hs-CRP,TC, TG, HDL-C or LDL-C, or common carotid artery IMT between the two groups （ P 〉 0.05 ）. After treatment, the levels of serum hs-CRP,TG,TC, LDL-C and common carotid artery IMT decreased while HDL-C level increased compared to those before treatment （ P 〈 0.05 ）, and the improvement of the indices above in the observation group was superior to that in the control group （ P 〈 0.05 ）. The total effective rate in the observation group was 90.9% （40/44） ,which was significantly better than that in the control group（52.3% ,23/44） （P 〈 0.05）. Conclusion The combination of clopidogrel sulfate and aspirin enteric-coated tablet is effective in the treatment of cerebral infarction,which can effectively improve serum hs-CRP and the indices of blood lipid and reduce common carotid artery IMT. It is worthy of clinical popularization.