氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块的效果及对血清Hcy水平、凝血功能、颈动脉内中膜厚度的影响

Effect of Clopidogrel Combined with Atorvastatin on Progressive Cerebral Infarction with Carotid Atherosclerotic Plaque and Its Influence on Serum Hcy Level,Coagulation Function and Carotid Intimamedia Thickness

目的:探讨氯吡格雷联合阿托伐他汀治疗进展性脑梗死伴颈动脉粥样斑块的效果及对血清同型半胱氨酸(Hcy)水平、凝血功能、颈动脉内中膜厚度的影响。方法:选取本院2016年3月-2018年5月确诊的进展性脑梗死伴颈动脉粥样斑块患者80例作为研究对象,按照随机数字表法将其分为观察组和对照组,各40例。两组在其他常规治疗相同的基础上,对照组给予氯吡格雷75 mg,观察组给予氯吡格雷75 mg联合阿托伐他汀20 mg,观察比较两组的临床疗效、治疗前后的血清Hcy、凝血功能水平及颈动脉内膜中层厚度(IMT)和斑块面积。结果:治疗后,两组Hcy水平、颈动脉IMT及斑块面积与治疗前比较均明显降低,且观察组均明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组PT、APTT水平与治疗前比较均明显升高,且观察组均明显高于对照组,差异均有统计学意义(P<0.05)。结论:与单一使用氯吡格雷相比,氯吡格雷联合阿托伐他汀使用治疗进展性脑梗死伴颈动脉粥样斑块具有显著效果,可以提高血清Hcy水平,改善凝血功能,降低IMT,具有较高的临床价值。

Objective:To investigate the effect of Clopidogrel combined with Atorvastatin in the treatment of progressive cerebral infarction with carotid atherosclerotic plaque and its influence on serum Hcy level,coagulation function and carotid intima-media thickness.Method:A total of 80 patients with progressive cerebral infarction complicated with carotid atherosclerotic plaque diagnosed in our hospital from March 2016 to May2018 were selected as the study objects.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was given Clopidogrel 75 mg,the observation group was given Clopidogrel 75 mg combined with Atorvastatin 20 mg on the basis of the same other conventional treatment.The clinical efficacy,serum Hcy,coagulation function,carotid intima-media thickness(IMT)and plaque area before and after treatment were observed and compared.Result:After treatment,the levels of Hcy,carotid IMT and plaque area in the two groups were significantly lower than those before treatment,the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of PT and APTT in the two groups were significantly higher than those before treatment,the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with Clopidogrel alone,Clopidogrel combined with Atorvastatin is effective in the treatment of progressive cerebral infarction with carotid atherosclerotic plaque.It can increase the level of serum Hcy,improve coagulation function and reduce IMT,and has higher clinical value.