不同剂量氯吡格雷对急性脑梗死患者血清细胞间黏附分子-1、P选择素水平及炎性因子的影响

Effects of Different Doses of Clopidogrel on Serum Intercellular Adhesion Molecule-1,P-Selectin Levels and Inflammatory Factors in Patients with Acute Cerebral Infarction

目的:探讨不同剂量氯吡格雷对急性脑梗死患者血清细胞间黏附分子-1(ICAM-1)、P选择素(CD62P)水平及炎性因子的影响。方法:选取2020年10月-2022年1月天津市北辰医院神经内科收治的急性脑梗死患者100例作为研究对象,按照随机数字表法分为大剂量组和小剂量组,各50例。患者均行常规对症治疗,大剂量组患者给予氯吡格雷150 mg/(d·次)进行治疗,小剂量组患者给予氯吡格雷75 mg/(d·次)进行治疗。比较抗血小板治疗效果,血清ICAM-1和CD62P水平,炎性因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-ɑ(TNF-ɑ)]水平。结果:治疗后,两组血小板计数和血小板聚集率均降低,大剂量组低于小剂量组,差异有统计学意义(P<0.05)。治疗后,两组ICAM-1和CD62P指标均下降,且大剂量组低于小剂量组,差异有统计学意义(P<0.05)。治疗后,两组炎性因子指标均降低,大剂量组IL-6、hs-CRP和TNF-ɑ指标低于小剂量组,差异有统计学意义(P<0.05)。结论:大剂量氯吡格雷对急性脑梗死患者抗血小板疗效较好,可有效降低血清ICAM-1、CD62P和炎性因子水平,改善患者炎性状态。

Objective:To explore the effects of different doses of clopidogrel on serum intercellular adhesion molecule-1(ICAM-1),P-selectin(CD62P)levels and inflammatory factors in patients with acute cerebral infarction.Methods:100 patients with acute cerebral infarction treated in the Neurology Department of Tianjin Beichen Hospital from October 2020 to January 2022 were selected as research subjects and divided into high-dose group and low-dose group according to the random number table method,with 50 cases in each group.All patients received conventional symptomatic treatment.Patients in the high-dose group were treated with clopidogrel 150 mg/(d·time),and patients in the low-dose group were treated with clopidogrel 75 mg/(d·time)at a conventional dose.Compare the antiplatelet treatment effect,serum ICAM-1 and CD62P levels,inflammatory factors[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-ɑ(TNF-ɑ)]level.Results:After treatment,the platelet count and platelet aggregation rate in both groups were reduced,and the high-dose group was lower than the low-dose group,and the difference was statistically significant(P<0.05);after treatment,ICAM-1 and CD62P indicators decreased in both groups,and the high-dose group was lower than the low-dose group,and the difference was statistically significant(P<0.05);after treatment,the inflammatory factor indicators in both groups were reduced.The IL-6,hs-CRP and TNF-ɑindicatorsinthehigh-dose group were lower than those in the low-dose group,and the difference was statistically significant(P<0.05).Conclusion:High-dose clopidogrel therapy has a good antiplatelet effect in patients with acute cerebral infarction.It can effectively reduce the levels of serum ICAM-1,CD62P and inflammatory factors and improve the inflammatory status of patients.