氯吡格雷联合前列地尔对急性脑梗死患者疗效、血流动力学及凝血功能水平的影响

Effect of clopidogrel combined with alprostadil on clinical efficacy,hemodynamics and coagulation function in patients with acute cerebral infarction

目的:探讨氯吡格雷联合前列地尔对急性脑梗死患者的疗效及对患者血流动力学、凝血功能水平的影响。方法:选取2015年6月-2017年6月某院收治的急性脑梗死患者90例,按照随机数字表法分为对照组与观察组,每组各45例。对照组患者在常规治疗基础上给予氯吡格雷治疗,观察组患者在对照组治疗基础上给予前列地尔治疗。比较2组患者临床治疗效果;检测治疗前、后2组患者血浆黏度(PV)、血浆纤维蛋白原(FIB)、血小板聚集率(PAR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)水平。结果:对照组患者治疗后临床总有效率为64.44%;观察组患者治疗后临床总有效率为86.67%。两者比较差异有显著性(P<0.05)。治疗前,2组患者血流动力学指标PV、FIB、PAR及凝血功能指标PT、APTT、D-D水平比较,差异无显著性(P>0.05)。治疗后,对照组及观察组患者PV、FIB、PAR及D-D水平均明显低于本组治疗前,PT、APTT水平均明显高于本组治疗前;观察组患者治疗后PV、FIB、PAR及D-D水平均明显低于对照组治疗后,PT、APTT水平均明显高于对照组治疗后,差异均有显著性(P<0.05)。结论:氯吡格雷联合前列地尔对急性脑梗死患者具有较好的临床疗效,可通过抑制血小板活性及降低血液黏度,起到改善患者血流动力学水平,调节患者凝血功能的作用。

OBJECTIVE To investigate the effect of Clopidogrel plus alprostadil on hemodynamics and coagulation function in patients with acute cerebral infarction. METHODS 90 patients with acute cerebral infarcti admitted to our hospital from June 2015 to June 2017 were randomly divided into control group and observation group, 45 cases in each group. The patients in control group were treated with clopidogrel on the basis of routine treatment, while the observation group was given alprostadil on the basis of treatment in the control group. The clinical therapeutic effects of the two groups were compared;plasma viscosity(PV), plasma fibrinogen(FIB), platelet aggregation rate(PAR), prothrombin time(PT), activated partial thromboplastin time(APTT), and D-dimer(D-D) levels were measured before and after treatment in the two groups. RESULTS The clinical total effective rate was 64.44% in the control group and 86.67% in the observation group. and the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in levels of PV, FIB, PAR, PT, APTT and D-D between the two groups(P>0.05). After treatment, the levels of PV, FIB, PAR and D-D of patients in the control group and the observation group were significantly lower than those before the treatment, and the levels of PT and APTT were significantly higher than those before the treatment. The levels of PV, FIB, PAR and D-D of patients in the observation group were significantly lower than those in the control group after treatment, and the levels of PT and APTT were significantly higher than those in the control group after treatment. The difference was statistically significant(P<0.05). CONCLUSION Clopidogrel combined with alprostadil showed good clinical efficacy in patients with acute cerebral infarction. It can improve hemodynamics and regulate coagulation function by inhibiting platelet activity and reducing blood viscosity.