西洛他唑与氯吡格雷用于急性期脑梗死的抗血小板作用比较

摘要

Objective To compare the anti - platelet effect between cilostazol and clopidogrel in patients with acute cerebral infarction. Methods From December 2013 to January 2015,a total of 72 in - patients with acute cerebral infarction were selected in the Department of Neurology,People's Hospital of Puning,and they were randomly divided into A group and B group,each of 36 cases. Based on conventional treatment,patients of A group were given cilostazol,patients of B group were given clopidogrel. Neurological function defect score before treatment and on the eighth day of treatment,platelet P - selectin and platelet fibrinogen receptor before treatment and on the third,eighth day of treatment were compared between the two groups,and incidence of adverse reactions during treatment were observed. Results No statistically significant differences of neurological function defect score was found between the two groups before treatment or on the eighth day of treatment( P > 0. 05). No statistically significant differences of platelet P - selectin or platelet fibrinogen receptor was found between the two groups before treatment or on the eighth day of treatment(P > 0. 05);while platelet P - selectin and platelet fibrinogen receptor of A group were statistically significantly higher than those of B group on the third day of treatment(P < 0. 05). No one of the two groups occurred obvious adverse reactions during treatment. Conclusion Both of cilostazol and clopidogrel have better anti - platelet effect in patients with acute cerebral infarction,which can effectively inhibit platelet aggregation,while clopidogrel has a relatively shorter onset time than cilostazol.%目的：比较西洛他唑与氯吡格雷用于急性期脑梗死的抗血小板作用。方法选择2013年12月—2015年1月广东省普宁市人民医院神经内科住院治疗的急性期脑梗死患者72例，随机分为西洛他唑组和氯吡格雷组，每组36例。在常规治疗基础上西洛他唑组加用西洛他唑治疗，氯吡格雷组加用氯吡格雷治疗。比较两组患者用药前及用药第8天神经功能缺损评分，用药前、用药第3天及用药第8天血小板 P -选择素（CD62P）、血小板纤维蛋白原受体（PAC -1）水平，同时观察治疗期间不良反应发生情况。结果两组患者用药前后神经功能缺损评分比较，差异无统计学意义（P ＞0.05）。用药第3天，氯吡格雷组血小板 CD62P、PAC -1 水平低于西洛他唑组（P ＜0.05）；用药前及用药第8天两组患者血小板 CD62P、PAC -1 水平比较，差异无统计学意义（P ＞0.05）。两组患者治疗期间均未出现明显不良反应。结论西洛他唑与氯吡格雷治疗急性期脑梗死均具有较好的抗血小板作用，能有效抑制血小板聚集，但氯吡格雷较西洛他唑起效快。