阿司匹林联合氯吡格雷治疗CIS的疗效及对患者ACA、MCA、PCA的影响  

Efficacy of aspirin combined with clopidogrel in the treatment of CIS patients and its impact on ACA,MCA,and PCA

作　　者：郭会月 王欣格 靳玫[1] 李凤鹏 GUO Hui-yue;WANG Xin-ge;JING Mei;LI Feng-peng(Department of Neurology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,Henan,CHINA)

机构地区：[1]新乡医学院第三附属医院神经内科,河南新乡453000

出　　处：《海南医学》2024年第13期1840-1843,共4页Hainan Medical Journal

基　　金：新乡医学院第三附属医院博士启动基金(编号:BSKYJF-李凤鹏)。

摘　　要：目的探讨阿司匹林联合氯吡格雷治疗急性缺血性脑卒中(CIS)的疗效及对患者双侧大脑前动脉(ACA)、双侧大脑中动脉(MCA)、双侧大脑后动脉(PCA)的影响。方法选择2020年1月至2023年1月新乡医学院第三附属医院神经内科收治的120例CIS患者进行研究,按随机数表法分为观察组和对照组,每组60例。两组患者均接受常规治疗,对照组患者在常规治疗基础上加用阿司匹林治疗,观察组患者在对照组治疗的基础上加用氯吡格雷治疗,所有患者均治疗1个月。比较两组患者的疗效,以及治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、神经生长相关蛋白43(GAP43)、血管内皮生长因子(VEGF)及ACA、MCA、PCA的变化,同时比较两组患者治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为93.33%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组患者的NIHSS评分、GAP43、VEGF均降低,且观察组患者的NIHSS评分、GAP43、VEGF分别为(3.98±0.91)分、(20.13±2.17)ng/L、(23.09±2.74)ng/L,明显低于对照组的(5.21±1.09)分、(27.28±2.42)ng/L、(30.71±3.01)ng/L,差异均有统计学意义(P<0.05);治疗后,两组患者的ACA、MCA、PCA均降低,且观察组患者的ACA、MCA、PCA分别为(51.28±3.27)cm/s、(70.93±5.20)cm/s、(40.21±3.01)cm/s,明显低于对照组的(56.27±3.09)cm/s、(76.21±4.82)cm/s、(45.21±3.74)cm/s,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为8.33%,略低于对照组的11.67%,但差异无统计学意义(P>0.05)。结论阿司匹林联合氯吡格雷治疗CIS患者的疗效显著,且能明显改善ACA、MCA、PCA水平,具有临床应用价值。Objective To explore the efficacy of aspirin combined with clopidogrel in the treatment of acute cerebral ischemic stroke(CIS)patients and its effects on bilateral anterior cerebral artery(ACA),bilateral middle cerebral artery(MCA),and bilateral posterior cerebral artery(PCA).Methods A total of 120 CIS patients admitted to Department of Neurology,the Third Affiliated Hospital of Xinxiang Medical College from January 2020 to January 2023 were selected and randomly divided into an observation group and a control groups using a random number table method,with 60 patients in each group.Both groups of patients received routine treatment.The control group received aspirin treatment in addition to routine treatment,while the observation group received clopidogrel treatment in addition to the control group,both for one month.After one month of treatment,the efficacy of two groups of patients were compared,as well as the National Institutes of Health Stroke Scale(NIHSS)scores,nerve growth associated protein 43(GAP43),vascular endothelial growth factor(VEGF),and changes in ACA,MCA,and PCA before and after treatment,and the adverse reactions.Results The total effective rate of the observation group was 93.33%,which was significantly higher than 80.00%of the control group(P<0.05).After treatment,the NIHSS,GAP43,and VEGF levels in both groups decreased,and the indexes in the observation group were(3.98±0.91)points,(20.13±2.17)ng/L,and(23.09±2.74)ng/L,which were significantly lower than(5.21±1.09)points,(27.28±2.42)ng/L,and(30.71±3.01)ng/L in the control group,with statistically significant differences(P<0.05).After treatment,the ACA,MCA,and PCA of both groups decreased,and the indexes of the observation group were(51.28±3.27)cm/s,(70.93±5.20)cm/s,and(40.21±3.01)cm/s,which were significantly lower than(56.27±3.09)cm/s,(76.21±4.82)cm/s,and(45.21±3.74)cm/s of the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the observation group was 8.33%,which was sligh

关 键 词：急性缺血性脑卒中 阿司匹林 氯吡格雷 疗效 颅内血流动力学 不良反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]