Objective To investigate the clinical effects of of plasma endothelin‐1 ,serum lipoprotein‐a in acute ischemic stroke treated with clopidogrel.Methods 134 patients with acute ischemic stroke in our hospital from January 2012 to March 2014 were selected and divided into the observation group and the control group according to the random number ,each group with 67 cases. The control group was given routine treatment ,the observation group received clopidogrel tablets on the basis of control group.Besides plasma big ET‐1 ,Lp (a) level ,neurological deficit ,daily life ability and cerebral blood flow velocity were detected before and after 1‐month ,3‐month ,6‐month treatment. Results After treatment ,the scores of NIHSS ,ADL and the levels of ET‐1 ,plasma big Lp(a) decreased significantly in two groups ,while VMCA increased significantly. The NIH‐SS scores ,ADL scores and VMCA levels in the observation group after 3‐month and 6‐month treatment were significantly im‐proved compared with both before treatment and the control group ,and the plasma big ET‐1 and Lp‐a levels were also signifi‐cantly lower in the observation group ,all with statistical differences (P<0.05).Conclusion Clopidogrel therapy has a signifi‐cant clinical effect on acute ischemic stroke ,which can promote the recovery of nerve function ,improve endothelial function , improve the quality of life ,and reduce the plasma big ET‐1 ,Lp(a) level which provide the evidence for predicting the progno‐sis.%目的：探讨氯吡格雷治疗急性缺血性脑卒中的临床效果及对患者血浆大内皮素1、血清脂蛋白（a ）的影响。方法将我院于2012‐01—2014‐03收治的诊断为急性缺血性脑卒中的患者134例，按照随机数字法将患者平均为观察组67例和对照组67例，入院后2组患者均给予常规治疗，观察组患者在此基础上给予氯吡格雷片治疗，观察2组患者治疗前后big ET‐1、Lp（a）的水平变化以及治疗前与治疗后1、3、6个月时患者的神经功能缺损情况、日常生活能力以及脑血管血流速度。结果2组患者经过治疗后NIHSS评分、ADL评分、血浆big ET‐1、Lp（a）的水平均有显著降低，而VMCA显著升高，其中观察组治疗后3个月及6个月时的NIHSS评分、ADL评分及VMCA水平均有显著改善，同时显著优于对照组，而观察组经过治疗后血浆big ET‐1、Lp（a）水平也显著低于对照组，差异均具有统计学意义（P＜0.05）。结论氯吡格雷治疗急性缺血性脑卒中临床效果显著，能够显著促进神经功能恢复，改善患者的血管内皮功能，提高生活质量，同时能够显著降低患者的血浆big ET‐1、Lp（a）水平，可通过血浆big ET‐1、Lp（a）水平对患者的预后预测提供依据。
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