氯吡格雷联合阿托伐他汀治疗老年急性脑梗死的效果及安全性分析

Clinical efficacy and safety of clopidogrel combined with atorvastatin in elderly patients with acute cerebral infarction

目的观察氯吡格雷联合阿托伐他汀治疗老年急性脑梗死的有效性和安全性。方法选取医院确诊的首发急性脑梗死老年患者120例为研究对象,随机分为两组,各60例。研究组患者给予口服氯吡格雷联合阿托伐他汀治疗;对照组患者给予口服阿司匹林联合阿托伐他汀治疗。治疗3个月后,观察评价两组患者Barthel指数、高敏C反应蛋白(hs-CRP)、血脂指标(TC、TG、LDL-C、HDL-C)变化及脑血管事件和不良反应发生情况。结果治疗3个月后,两组患者Barthel指数和hsCRP较治疗前明显改善(P <0. 01),且研究组较对照组改善更显著(P <0. 01);两组患者各项血脂指标较治疗前均明显改善(P <0. 01),且研究组改善情况优于对照组(P <0. 01);研究组脑血管事件再发率低于对照组(P <0. 05),两组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论氯吡格雷联合阿托伐他汀治疗老年急性脑梗死,能有效改善临床症状,调控血脂,抑制炎性因子,降低复发率,值得临床推广应用。

Objective To evaluate the efficacy and safety of clopidogrel combined with atorvastatin in the treatment of acute cerebral infarction in the elderly. Methods Randomly divided 120 cases of elderly acute cerebral infarction into research group and control group,each group with 60 cases.The research group took clopidogrel plus atorvastatin,while the control group did aspirin and atorvastatin.The serum concentrations of hs-CRP,TC,TG,LDL-C and HDL-C,as well as Barthel index,recurrence of cerebrovascular events and incidence of adverse reactions,were collected after 3 months. Results Barthel index,hs-CRP and blood lipids in the two groups improved significantly after treatment compared with their post-treatment（ P 〈0.01）,and those of the research group changed much more than control group（ P 〈0.01）.The research group had significantly lower cerebrovascular events incidence than the control group（ P 〈0.05）,and no statistical difference in adverse reaction incidence occurred between the two（ P 〉0.05）. Conclusion The combination of clopidogrel and atorvastatin alleviated clinical manifestations,lowered blood lipids,inhibited inflammatory factors and reduced the recurrence rate in elderly patients with acute cerebral infarction.