负荷剂量氯吡格雷对急性进展型脑梗死患者血液流变学及神经功能的影响  

Effects of a loading dose of clopidogrel hydrogen sulfate on hemorheology and neurological function in patients with acute progressive cerebral infarction

作　　者：钱辉 彭银花 景江 Qian Hui;Peng Yinhua;Jing Jiang(Department of Neurological Rehabilitation,the Affiliated Hospital of Shaoxing University,Shaoxing 312000,Zhejiang Province,China)

机构地区：[1]绍兴文理学院附属医院神经康复科,312000

出　　处：《中国基层医药》2021年第7期983-987,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨负荷剂量氯吡格雷对急性进展型脑梗死患者血液流变学及神经功能的影响。方法选取绍兴文理学院附属医院2018年1月至2019年1月诊治的急性进展型脑梗死患者110例为研究对象,按照简单随机分组法分为对照组和研究组,每组55例。对照组患者予常规治疗,研究组患者在常规治疗的基础上予负荷剂量氯吡格雷治疗。治疗2周后,比较两组患者治疗前后血液流变学、神经功能缺损程度评分及不良反应发生情况。结果治疗后两组患者血液流变学指标均明显降低,研究组患者血浆黏度(PV)[(1.01±0.37)mPa/s]、全血高切黏度(BVH)[(4.23±0.35)mPa/s]、全血低切黏度(BVL)[(8.36±1.64)mPa/s]、纤维蛋白原(FIB)[(1.23±0.28)g/L]及红细胞比容(HCT)[(40.08±5.04)%]水平均明显低于对照组[(1.84±0.52)mPa/s、(5.44±0.39)mPa/s、(10.54±1.79)mPa/s、(2.30±0.37)g/L、(44.36±5.12)%],均差异有统计学意义(t=5.485、8.594、9.523、7.789、11.236,P=0.019、0.006、0.004、0.007、0.001);治疗后两组美国国立卫生研究院卒中量表(NIHSS)评分均明显降低,且研究组患者NIHSS评分[(3.11±1.17)分]明显低于对照组[(6.43±2.25)分](t=10.416,P=0.003);研究组患者不良反应发生率为5.45%(3/55),与对照组的9.09%(5/55)差异无统计学意义(χ^(2)=0.539,P=0.463)。结论负荷剂量氢氯吡格雷治疗急性进展型脑梗死的效果显著,可明显改善患者血液流变学指标及神经功能。Objective To investigate the effects of a loading dose of clopidogrel hydrogen sulfate on hemorheology and neurological function in patients with acute progressive cerebral infarction.Methods A total of 110 patients with acute progressive cerebral infarction who received treatment between January 2018 and January 2019 in the Affiliated Hospital of Shaoxing University,China were included in this study.They were randomly assigned to receive either conventional treatment(control group,n=55)or treatment with a loading dose of clopidogrel hydrogen sulfate based on conventional treatment(study group,n=55)for 2 weeks.Hemorheological parameters,National Institute Health of Stroke Scale(NIHSS)scores and adverse reactions were compared between the study and control groups.Results After treatment,the levels of hemorheological parameters in both groups were obviously decreased.Plasma viscosity,high-shear whole blood viscosity,low-shear whole blood viscosity,fibrinogen level and hematocrit in the study group were(1.01±0.37)mPa/s,(4.23±0.35)mPa/s,(8.36±1.64)mPa/s,(1.23±0.28)g/L,(40.08±5.04)%,respectively,which were significantly lower than those in the control group[(1.84±0.52)mPa/s,(5.44±0.39)mPa/s,(10.54±1.79)mPa/s,(2.30±0.37)g/L,(44.36±5.12)%,t=5.485,8.594,9.523,7.789,11.236,P=0.019,0.006,0.004,0.007,0.001].After treatment,NIHSS scores in the study group were significantly lower than those in the control group[(3.11±1.17)points vs.(6.43±2.25)points,t=10.416,P=0.003).There was no significant difference in the incidence of adverse reactions between study and control groups[5.45%(3/55)vs.9.09%(5/55),χ^(2)=0.539,P=0.463).Conclusion The loading dose of clopidogrel hydrogen sulfate is highly effective in the treatment of acute progressive cerebral infarction and it can greatly improve hemorheological parameters and neurological function.

关 键 词：脑梗死 血液流变学 氯吡格雷 阿司匹林 药物剂量 血小板 血小板聚集抑制剂 神经损伤 治疗结果 药物不良反应 

分 类 号：R743.33[医药卫生—神经病学与精神病学]