氯吡格雷联合前列地尔治疗大脑中动脉狭窄引起的急性脑梗死患者的临床观察

Clinical observation of Clopidogrel Combined with Alprostadil in the Treatment of Acute Cerebral Infarction Caused by Middle Cerebral Artery Stenosis

目的分析氯吡格雷联合前列地尔治疗大脑中动脉狭窄引起的急性脑梗死患者的临床疗效。方法选取2016年1月至2018年12月我院收治的96例大脑中动脉狭窄引起的急性脑梗死患者,随机分为两组各48例。常规组采用常规治疗,联合组在常规治疗基础上加用氯吡格雷及前列地尔治疗。比较两组的临床疗效、不良反应,以及治疗前后的血流动力学相关指标、炎性因子水平。结果联合组的治疗总有效率为95.8%,显著高于常规组的79.2%(P <0.05);两组的不良反应发生率无统计学差异(P>0.05)。治疗后,联合组的血浆黏度、血浆纤维蛋白原及血小板聚集率均显著低于常规组(P <0.05), hs-CRP、 IL-6、 IL-8水平均显著低于常规组(P <0.05)。结论氯吡格雷联合前列地尔治疗大脑中动脉狭窄引起的急性脑梗死疗效确切,可有效改善患者的血流动力学指标,缓解炎性反应。

Objective To analyze the clinical efficacy of clopidogrel combined with alprostadil in the treatment of acute cerebral infarction(ACI)caused by middle cerebral artery stenosis.Methods 96 patients with ACI caused by middle cerebral artery stenosis in our hospital from January 2016 to December 2018 were selected and randomly divided into two groups,with 48 cases in each group.The routine group received routine treatment,and the combined group received clopidogrel combined with alprostadil treatment on the basis of routine treatment.The clinical efficacy,adverse reactions,and the levels of hemodynamic related indicators and inflammatory factors before and after treatment were compared between the two groups.Results The total effective rate of treatment of combined group was 95.8%,significantly higher than 79.2%of routine group(P<0.05).No statistical difference was found between two groups in the incidence of adverse reactions(P>0.05).After treatment,the plasma viscosity,plasma fibrinogen and platelet aggregation rate,as well as the levels of hs-CRP,IL-6 and IL-8 of combined group were significantly lower than those of routine group(P<0.05).Conclusions Clopidogrel combined with alprostadil in the treatment of ACI caused by middle cerebral artery stenosis has exact efficacy,which can effectively improve patients’hemodynamic indicators,and relieve the inflammatory reaction.