氯吡格雷对后循环脑梗死患者神经功能、血小板活化程度及MCP-1水平的影响

Effects of clopidogrel on nerve function,platelet activation,and MCP-1 level in patients with post-circulation cerebral infarction

目的:探究给予后循环脑梗死患者氯吡格雷药物治疗后,对患者神经功能、血小板活化程度及单核细胞趋化蛋白-1(Monocyte chemoattractant protein-1,MCP-1)水平的影响。方法:选取我科2021年1月至2022年5月期间89例后循环脑梗死患者为研究对象,根据随机数字表法分为两组。对照组患者44例口服阿司匹林100 mg治疗,观察组45例患者联合口服氯吡格雷75 mg治疗。分别于患者治疗前及治疗2 w后,应用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、Barthel指数评定量表评估患者的神经功能水平;使用流式细胞分析仪检测患者α颗粒膜糖蛋白(Alpha particle membrane glycoprotein,CD62p)、溶酶体颗粒膜糖蛋白(Lysosomal granule membrane glycoprotein,CD63)及血小板-单核细胞聚集体(Platelets-aggregates of monocytes,PMA)的阳性表达率;应用酶联免疫吸附法检测患者的超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)、MCP-1水平;在患者住院治疗期间,统计两组患者不良反应总发生率。结果:治疗后,观察组患者NIHSS评分低于对照组,Barthel指数高于对照组(P<0.05);治疗后,观察组患者CD62p、CD63及PMA阳性表达率均低于对照组(P<0.05);治疗后,观察组患者hs-CRP、IL-1β、MCP-1水平均低于对照组(P<0.05);住院期间,两组患者颅内出血、血小板减少症、不良反应总发生率对比无明显差异(P>0.05)。结论:氯吡格雷可以提高患者的神经功能,改善血小板活化程度,降低炎症因子水平,药物安全性高。

Objective:To explore the effects of clopidogrel treatment on nerve function,platelet activation,and the level of monocyte chemoattractant protein-1(MCP-1)in patients with post-circulation cerebral infarction.Methods:Eighty-nine patients with post-circulation cerebral infarction in our department from January 2021 to May 2022 were selected as subjects and divided into two groups according to the random number table method.Forty-four patients in the control group were treated with aspirin(100 mg,orally),while 45 patients in the observation group were treated with clopidogrel(75 mg,orally).National Institutes of Health Stroke Scale(NIHSS)score and Barthel Index rating scale were used to evaluate the neurological function of patients before and 2 weeks after treatment,respectively.Alpha particle membrane glycoprotein(CD62p),the positive expression rate of lysosomal granule membrane glycoprotein(CD63),and platelets-aggregates of monocytes(PMA)were detected by flow cytometry.The levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),and MCP-1 were detected by enzyme-linked immunosorbent assay.During hospitalization,the total incidence of adverse reactions in the two groups was analyzed.Results:After treatment,the NIHSS score in the observation group was lower than the control group,and the Barthel index was higher than the control group(P<0.05).After treatment,the positive expression rates of CD62p,CD63,and PMA in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of hs-CRP,IL-1β,and MCP-1 in the observation group were lower than those in the control group(P<0.05).During hospitalization,there were no significant differences in the total incidence of intracranial hemorrhage,thrombocytopenia,and adverse reactions between the two groups(P>0.05).Conclusion:Clopidogrel can improve the neurological function of patients,improve the degree of platelet activation,and reduce the levels of inflammatory factors,with high safety.