目的:探讨氯吡格雷与依达拉奉联合治疗急性脑梗死(ACI)的临床疗效及其对患者血浆内皮素(ET)、血清炎症因子的影响.方法:将124例ACI患者按随机数字表法分为两组,观察组(n=62)采用氯毗格雷联合依达拉奉治疗,对照组(n=62)单用氯吡格雷治疗.治疗前及治疗14 d后,测定两组的血浆内皮功能指标[ET-1、一氧化氮(NO)]、血清炎症因子[C反应蛋白(CRP)、白细胞介素(IL)-6、IL-8、IL-10],比较两组的临床疗效、神经功能缺损评分(NIHSS)及日常生活活动能力(ADL)评分.结果:观察组总有效率为95.16％,高于对照组的79.03％(P＜0.05);治疗14d后,观察组的NIHSS评分显著低于治疗前及对照组(P＜0.05),而ADL评分显著高于治疗前及对照组(均P＜0.05);观察组的血浆NO显著高于治疗前及对照组(均P＜0.05),而血浆ET-1、血清CRP、IL-6 、IL-8 、IL-10均显著低于治疗前及对照组(均P＜o.05).结论:氯吡格雷与依达拉奉联合治疗ACI疗效确切,较单独应用氯吡格雷更能够增强患者ADL并改善神经功能缺损,可能与改善血管内皮功能及下调血清炎症因子表达有关.%Objective:To evaluate the clinical efficacy and effect of clopidogrel combined with edaravone on plasma endothelin (ET) and serum inflammatory factors levels in patients with acute cerebral infarction (ACI).Methods:124 patients with ACI were selected and randomly divided into an observation group and a control group,with 62 cases in each group.The patients in the observation group received clopidogrel and edaravone,while those in the control group received only clopidogrel.The levels of ET andnitric oxide (NO) in plasma and the C-reactive protein (CRP),interleukin (IL)-6,IL-8 and IL-101evels in serum were detected.The efficacy,National Institute of Health stroke scale (NIHSS) scores and activities of daily living (ADL) scores were compared between the two groups.Results:The total response rate in the observation group was 95.16％,which was higher than that in the control group (79.03％)(P ＜0.05).At 14 d posttreatment,the NIHSS scores,plasma ET and serum CRP,IL-6,IL-8 and IL-10 levelswere significantly lower,while the ADL scores,plasma NO level were significantly higherin the observation group than those before treatment or the control group (P ＜0.05).Conclusion:Combination administration of clopidogrel and edaravonewas effective in treating ACI.It could improve neurological deficits of patients due to improving endothelial function and attenuate the inflammatory response.
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