阿司匹林联合氯吡格雷治疗急性缺血性脑卒中的临床疗效及其对血清同型半胱氨酸水平的影响

摘要

目的 观察阿司匹林联合氯吡格雷治疗急性缺血性脑卒中的临床疗效,并探讨其对血清同型半胱氨酸(Hcy)水平的影响.方法 选择2016年8月—2017年6月启东市人民医院神经内科收治的急性缺血性脑卒中患者132例,采用随机数字表法分为对照组和观察组,每组66例.在常规治疗基础上,对照组患者给予阿司匹林治疗,观察组患者给予阿司匹林联合氯吡格雷治疗;两组患者均连续治疗1个月.比较两组患者临床疗效,治疗前及治疗后2周、1个月血清Hcy水平,并观察两组患者治疗期间不良反应发生情况.结果 观察组患者临床疗效优于对照组(P<0.05).治疗前两组患者血清Hcy水平比较,差异无统计学意义(P>0.05);治疗后2周、1个月,观察组患者血清Hcy水平低于对照组(P<0.05).两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05).结论 阿司匹林联合氯吡格雷治疗急性缺血性脑卒中的临床疗效确切,可有效降低血清Hcy水平,有利于减轻神经毒性、改善患者预后.%Objective To observe the clinical effect of aspirin combined with clopidogrel on acute ischemic stroke, to investigate the impact on serum homocysteine level.Methods From August 2016 to June 2017,a total of 132 patients with acute ischemic stroke were selected in the Department of Neurology,the People's Hospital of Qidong,and they were divided into control group and observation group according to random number table,each of 66 cases. Based on conventional treatment, patients in control group received aspirin only,while patients in observation group received aspirin combined with clopidogrel;both groups continuously treated for 1 month. Clinical effect,serum homocysteine level before treatment,2 weeks and 1 month after treatment,and incidence of adverse reactions during treatment were compared between the two groups.Results Clinical effect in observation group was statistically significantly better than that in control group(P<0.05). No statistically significant differences of serum homocysteine level was found between the two groups before treatment(P>0.05),while serum homocysteine level in observation group was statistically significantly lower than that in control group 2 weeks and 1 month after treatment,respectively(P<0.05). No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Aspirin combined with clopidogrel has certain clinical effect in treating patients with acute ischemic stroke,can effectively reduce the serum homocysteine level,is helpful to relieve the neurotoxicity and improve the prognosis.