阿司匹林联合氯吡格雷对急性缺血性脑卒中患者细胞炎症因子及凝血功能的影响

Effects of Aspirin Combined Clopidogrel on Cellular Inflammatory Factors and Coagulation in Patients with Acute Ischemic Stroke

目的探讨阿司匹林联合氯吡格雷对急性缺血性脑卒中(acute ischemic stroke,AIS)患者细胞炎症因子、凝血功能及神经功能恢复的影响。方法选取作者医院112例AIS患者进行研究,随机分为对照组(n=58)和观察组(n=54),在常规治疗的基础上,对照组患者给予阿司匹林治疗,观察组在对照组的基础上联用氯吡格雷治疗,观察两组患者治疗前后细胞炎症因子超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6),凝血功能即凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)、D-二聚体及美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)变化和不良反应发生情况。结果治疗14天后,两组患者hs-CRP、FIB、D-二聚体水平均较治疗前明显下降,PT、APTT明显升高(P<0.05),且观察组治疗后hs-CRP、FIB、D-二聚体水平均明显低于对照组,PT、APTT明显高于对照组(P<0.05),治疗后两组患者的IL-6水平低于治疗前,但组间比较差异无统计学意义(P>0.05);患者治疗后1个月,观察组患者NIHSS评分均低于对照组,且两组患者评分差异具有统计学意义(P<0.05);治疗3个月后,观察组总有效率(96.29%)高于对照组(82.75%),组间比较差异有统计学意义(P<0.05);两组安全性均较好,未发生严重的不良事件,两组患者不良反应发生率之间对比差异无统计学意义(P>0.05)。结论阿司匹林联合氯吡格雷治疗AIS患者,可显著降低患者炎症反应、改善患者的凝血功能及神经功能缺损程度。

Objective To investigate the effects of aspirin combined clopidogrel on cellular inflammatory factors, coagulation function and neurological recovery in patients with acute ischemic stroke(AIS). Methods A total of 112 AIS patients from author′s hospital were randamly selected and divided into control group(n=58) and observation group(n=54). Patients in the control group were treated with aspirin on the basis of conventional treatment and patients in the observation group were treated with clopidogrel on the basis of the control group. The hypersensitive C-reactive protein(hs-CRP), interleukin-6(IL-6), coagulation function as well as prothrombin time(PT), fibrinogen(FIB), activated partial thromboplastin time(APTT) D-dimer and national institute of health stroke scale(NIHSS) changes and adverse effects in the two groups were observed before and after treatment. Results After 14 days of treatment, hs-CRP, FIB and D-dimer levels in both groups decreased significantly compared with those before, PT,APTT significantly increased(P<0.05), and hs-CRP, FIB and D-dimer levels in the observation group were significantly lower than those in the control group after treatment, and PT and APTT were significantly higher than those in the control group(P<0.05), after treatment, the IL-6 levels of patients in both groups were lower than those before treatment, while there was no significant difference between the two groups(P<0.05);the NIHSS scores of patients in the observation group were lower than those of patients in the control group at the 1st month after treatment, and the difference between the two groups was statistically significant(P<0.05);after 3 months of treatment, the total effective rate of the observation group(96.29%) was higher than that of the control group(82.75%), and the difference between the groups was statistically significant(P<0.05);both groups had a better safety profile, no serious adverse events occurred, and there was no statistical difference between the incidence of adverse reactions in the two groups(P>0.05). Conclusion Aspirin combined clopidogrel in the treatment of AIS patients can significantly reduce the inflammatory response, improve the coagulation function and the degree of neurological deficits in AIS patients.