氯吡格雷联合前列地尔治疗急性脑梗死的疗效及对患者血液流变学指标与炎性因子水平的影响

Curative effect of clopidogrel combined with alprostadil on acute cerebral infarction and its effect on hemorheology and inflammatory factor levels

目的分析氯吡格雷联合前列地尔治疗急性脑梗死（ACI）的疗效及对患者血液流变学指标与炎性因子水平的影响。方法选择82例ACI患者，以随机数字表法分为观察组和对照组，每组4l例。对照组采用常规综合治疗，观察组加用氯吡格雷联合前列地尔治疗，统计两组治疗2周后总有效率、不良反应发生率，并对比治疗前和治疗2周后两组血小板凝聚率（PAR）、血液流变学指标[全血低切黏度（WBLSV）、血浆黏度（PV）、全血高切黏度（HBV）]、炎性因子[白细胞介素-6（IL-6）、c反应蛋白（CRP）]水平。结果治疗2周后，观察组总有效率[90．24％（37／41）]高于对照组[68．29％（28／41）]，差异有统计学意义（P〈0．05）；观察组治疗2周后PAR、WBLSV、PV、HBV明显低于对照组，差异有统计学意义（P〈0．05）；与治疗前相比，治疗2周后两组IL-6、CRP均降低，且观察组低于对照组，差异有统计学意义（P〈0．05）；两组治疗期间血常规、肝肾功能检查等均未见异常，仅观察组出现1例皮疹。结论氯吡格雷联合前列地尔治疗急性脑梗死可改善患者血液流变学状态，缓解机体炎症反应，提高疗效，且安全性高。

Objective To investigate the curative effect of clopidogrel combined with alprostadil on acute cerebral infarction and its effect on hemorheology and inflammatory factor levels. Methods A total of 82 ACI patients were randomly divided into observation group and control group, with 41 cases in each group. The control group was given conventional treatment, and the observation group were treated with clopidogrel combined with alprostadil. The total effective rates and adverse reaction rates of the two groups after 2 weeks were statistically analyzed. And before treatment and 2 weeks after treatment, PAR, platelet aggregation rate indexes [ low blood viscosity blood flow （WBLSV）, plasma viscosity （PV）, whole blood viscosity（HBV） ], inflammatory cytokine [ interlcukin-6 （IL-6）, C- reactive protein（CRP） ] were compared. Results After 2 weeks of treatment, the total effective rate of the observation group was 90. 24% （37/41）, and which was higher than that of the control group [68.29% （28/41） ], the difference was significant （ P 〈 0. 05 ）. The levels of PAR, WBLSV, HBV, PV in the observation group after 2 weeks of treatment were lower than those of the control group, the differences were significant （P 〈 0. 05）. Compared with before treatment, 2 weeks after treatment, the levels of IL-6, CRP were reduced, and the levels of the observation group were lower than those of the control group, the differences were significant （P 〈 0.05 ）. The blood routine and liver function examination showed no abnormality. There was one case of medicine rash in the observation group. Conclusions Clopidogrel combined with alprostadil can improve the hemorheology of patients with acute cerebral infarction, and it can alleviate the body inflammatory response and improve efficacy. Also it has high security.