阿托伐他汀联合氯吡格雷治疗对急性脑梗死患者炎症因子、凝血功能及血小板活化的影响研究

Effect of atorvastatin and clopidogrel on inflammatory factors,blood coagulation and platelet activation in patients with acute cerebral infarction

目的:探讨阿托伐他汀联合氯吡格雷治疗对急性脑梗死患者炎症因子、凝血功能及血小板活化的影响。方法:将经临床及影像学确诊的140例急性脑梗死患者,随机分为治疗组70例和对照组70例。两组治疗前均进行常规治疗,观察组采用氯吡格雷与阿托伐他汀联合治疗,对照组采用阿司匹林与阿托伐他汀联合治疗。比较两组治疗前后的炎症因子、凝血功能及血小板活化指标水平的变化。结果:治疗前,两组炎症因子sICAM-1、TGF-β,凝血功能PT、APTT、FIB及血小板活化指标CD62p、CD63、PMA水平比较,差异不具有统计学意义(P>0.05)。治疗后,两组sICAM-1、CD62p、CD63及PMA、FIB水平均有所降低,TGF-β、PT、APTT水平均有所升高;观察组sICAM-1、FIB、CD62p、CD63、PMA均低于对照组,TGF-β、PT、APPT高于对照组,差异均具有统计学意义(P<0.05)。结论:阿托伐他汀联合氯吡格雷治疗能有效缓解急性脑梗死患者的炎症应激反应并减少炎症因子的释放,改善凝血功能,抑制血小板聚集,值得临床进一步推广。

Objective：To investigate the effects of atorvastatin combined with clopidogrel on inflammatory factors,coagulation and platelet activation in patients with acute cerebral infarction.Methods：140 cases patients with acute cerebral infarction who were confirmed by clinical and imaging diagnoses were randomly divided into treatment group（70 cases）and control group（70 cases）.Both groups were treated routinely before treatment.The observation group was treated with clopidogrel and atorvastatin,while the control group was treated with aspirin and atorvastatin.The changes of inflammatory factors,coagulation function and platelet activation index before and after treatment were compared between the two groups.Result：Before treatment,the levels of serum soluble intercellular adhesion molecule-1（sICAM-1）,transforming growth factor-β（TGF-β）,coagulation parameters prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,coagulation index of platelets plateletα-membrane glycoprotein（CD62 p）,lysosomal granular membrane glycoprotein（CD63）,plateletmonocyte aggregates（PMA）,coagulation parameters were not statistically significant（P〈0.05）.After treatment,the levels of sICAM-1,CD62 p,CD63,PMA and FIB in both groups decreased and the levels of TGF-β,PT and APTT increased.The levels of sICAM-1,FIB,CD62 p,CD63 and PMA in the observation group were（370.32±37.13）ng/mL,（1.97±0.21）g/L,（1.38± 0.14）%,（0.22±0.02）%,and（18.47＋1.85）% respectively,which were lower than those in the control group[（410.47±42.32）ng/mL,（2.58±0.26）s,（2.67 ± 0.27）%,（0.35 ± 0.03）% and（22.87 ± 2.91）% ].While the levels of TGF-β,PT and APPT were（231.53 ± 23.52）ng/mL,（15.42 ± 1.53）s,（37.31 ± 3.54）s were higher than the control group[（218.56±22.17）ng/mL,（12.32±1.27）s and（29.89±3.01）s].And the differences were significant（P〈0.05）.Conclusion：Atorvastatin combined with clopidogrel treatment can effectively relieve the inflammatory response,reduce the release of inflammatory cytokines,improve blood coagulation and inhibit platelet aggregation in patients with acute cerebral infarction.So it deserves further clinical promotion.