氯吡格雷联合阿托伐他汀治疗老年急性脑梗死的临床观察  

Clinical Study of Clopidogrel Combinedwith Atorvastatin in the Treatment of Elderly Patients with Acute Cerebral Infarction

作　　者：苏微微 饶世俊 潘丹 吴宝水 张雅 Su Weiwei;Rao Shijun;Pan Dan;Wu Baoshui;Zhang Ya(Department of Neurology,Petroleum Clinical Medicine College of Hebei Medical University(Central Hospital of Hebei China National PetroleumCorporation),Langfang,Hebei,065000,P.R.China;Department of Neurology,Shanghai Changhai Hospital,Shanghai,200433,P.R.China)

机构地区：[1]河北医科大学石油临床医学院(河北中石油中心医院)神经内科,河北廊坊065000 [2]上海长海医院神经内科,上海200433

出　　处：《老年医学与保健》2020年第6期1033-1036,共4页Geriatrics & Health Care

摘　　要：目的观察氯吡格雷联合阿托伐他汀治疗老年急性脑梗死患者的临床效果,为治疗该病提供方法。方法选取2019年5月-2020年5月在河北中石油中心医院就诊的急性期脑梗死患者84例,依据随机数字表法分为2组:观察组(n=42)和对照组(n=42)。对照组在常规治疗基础上予以阿托伐他汀治疗,观察组在对照组的治疗基础上加用氯吡格雷治疗,2组疗程均为12周。评估并比较2组血脂水平、凝血功能、颈动脉斑块、血流动力学变化、血小板功能、神经功能和生活自理能力。结果治疗后,2组血总胆固醇(TC)、低密度脂蛋白(LDL-C)和甘油三酯(TG)水平均明显低于同组治疗前,凝血酶原时间(PT)水平高于同组治疗前,而观察组上述指标比对照组均改善更明显,差异均有统计学意义(P<0.05);2组颈部内中膜厚度(IMT)和血小板聚集率均低于同组治疗前,平均血流速度均高于同组治疗前,而观察组比对照组均改善更明显,差异均有统计学意义(P<0.05);2组改良RANKIN量表(mRS)评分和美国国立卫生研究院卒中量表(NIHSS)评分均低于同组治疗前,Barthel指数(BI)评分高于同组治疗前,而观察组上述指标比对照组均改善更明显,差异均有统计学意义(P<0.05)。结论氯吡格雷联合阿托伐他汀治疗老年急性脑梗死的疗效显著,可有效降低患者血脂水平,稳定颈动脉斑块,改善血流动力学指标、凝血功能、血小板功能和神经功能,提高患者的日常生活自理能力。Objective To observe the clinical effect of clopidogrel combined with atorvastatin in the treatment of elderly patients with acute cerebral infarction(ACI).Methods 84 elderly patients with ACI who were treated in the Central Hospital of Hebei China National Petroleum Corporation fromMay 2019 to May 2020 were selected and divided randomly into the control group(n=42)and the observation group(n=42).The control group was treated with atorvastatin on the basis of conventional treatment,and the observation group was treated with clopidogrel on the basis of the control group.The course of treatment was 12 weeks in both groups.Blood lipid level,coagulation function,carotid plaque,hemodynamic changes,platelet function,nerve function and self-care ability were evaluated and compared between the two groups.Results After treatment,the levels of total cholesterol(TC),lowdensity lipoprotein(LDL-C)and triglyceride(TG)of the two groups were significantly lower than those of the same group before treatment,and the prothrombin time(PT)level of the two groups was higher than that of the same group before treatment,while the above indexes of the observation group were improved more significantly than those of the control group,and the differences were statistically significant(P<0.05);the carotid artery intima-media thickness(IMT)and platelet aggregation rate of the two groups were lower than those of the same group before treatment,and the average blood flow velocity was higher than that of the same group before treatment,while the observation group improved more significantly than the control group and the differences were statistically significant(P<0.05);the modified RANKINScale(MRS)scores and the National Institutes of Health Stroke Scale(NIHSS)scores of the two groups were lower than those of the same group before treatment,and the Barthel index(BI)score was higher than that of the same group before treatment.The above indexes of the observation group were better than those of the control group,and the differences were statis

关 键 词：老年 急性脑梗死 氯吡格雷 阿托伐他汀 血脂 日常生活能力 

分 类 号：R743.33[医药卫生—神经病学与精神病学]