氯吡格雷联合前列地尔治疗大脑中动脉狭窄致脑梗死的临床研究  

Clinical trial of clopidogrel combined with alprostadil in the treatment of cerebral infarction induced by middle cerebral artery stenosis

作　　者：虞莉娜[1] 刘进香[1] 席刚明[1] 

机构地区：[1]上海市徐汇区中心医院神经内科,上海200031

出　　处：《中国临床药理学杂志》2016年第12期1063-1065,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察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的临床疗效和安全性。方法 108例大脑中动脉狭窄引起的脑梗死患者随机分为对照组和试验组,各54例。对照组给予常规补液治疗,同时口服阿司匹林肠溶片100 mg,每天1次;试验组给予常规补液治疗,同时口服氯吡格雷75 mg,静脉注射前列地尔10μL,每天1次,2组疗程均为14 d。治疗7,14 d后,用美国国立卫生研究院卒中量表(NIHSS)评分和日常生活活动能力评分(ADL)评价2组患者的恢复情况。治疗14 d后,检测患者的血浆黏度、血浆纤维蛋白原及血小板聚集率等血流动力学的指标,同时,比较2组不良反应发生情况。结果与治疗前相比,2组治疗后临床症状显著改善(P<0.05);试验组NIHSS评分、ADL评分显著优于对照组(P<0.05)。试验组总有效率为94.4%,显著高于对照组的79.6%(P<0.05);痊愈率(27.8%)显著高于对照组(11.1%,P<0.05)。试验组血流动力学指标的恢复显著优于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(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患者临床疗效显著,能有效改善神经功能恢复,有效恢复脑梗死患者血流动力学指标,控制病情发展,且不增加不良反应的发生率。Objective To investigate the clinical efficacy and safety of clopidogrel combined alprostadil in the treatment of cerebral infarction induced by middle cerebral artery stenosis. Methods A total of 108 cere- bral infarction patients were collected in this study. Fifty -four patients in control group were treated with routine therapy and aspirin 100 mg, qd for 14 d. And 54 patients in treatment group were treated with the routine treatment and clopidogrel 75 mg combined with alprostadil injection 10 μL, qd for 14 d. The National institute of heahh stroke scale （NIHSS） and activity of daily life（ADL） score were used to evaluate the recovery of two groups after 7, 14 d. The hemorheology indexes including the whole blood viscosity, plasma fibrinogen and platelet adhesion rate after 14 d treatment were determined, and the adverse reactions were recorded in two groups. Results After treatment, the symptoms of patients in two groups were significantly improved compared with those before treatment （P 〈 0. 05）. The NIHSS and ADL scores of patients in treatment group were significantly better than those in control group（P significantly higher than that of control group （79. 6% significantly higher than that in control group （ 11.1% 〈0. 05）. The total efficiency of treatment group （94. 4% ） was , P 〈 0. 05 ）. The recovery rate in treatment group（27. 8 % ）was , P 〈 0. 05 ）. Hemorheology index showed that the recovery of patients in treatment group were significantly better than that in control group （ P 〈 0. 05 ）. The incidence of adverse reactions in two groups had no significant difference （P 〉 0. 05 ）. Conclusion Clopidogrel combined with alprostadil is good to treat the acute cerebral infarction caused by middle cerebral artery stenosis, which can effectively improve the neural function recovery and the hemorheology indexes without the increase of the incidence of adverse reactions.

关 键 词：氯吡格雷 前列地尔 中动脉狭窄 脑梗死 

分 类 号：R973[医药卫生—药品]