摘要
目的观察老年急性脑梗死患者应用氯吡格雷联合阿托伐他汀钙及阿司匹林的治疗效果。方法选取98例老年急性脑梗死患者作为研究对象,根据电脑随机法分成观察组和对照组,各49例。对照组给予氯吡格雷治疗,观察组在对照组基础上加用阿托伐他汀钙及阿司匹林治疗。比较两组治疗前后炎性因子、血液流变学指标、脑神经递质水平、脑部功能及日常生活能力。结果两组治疗前白细胞介素-6、超敏C反应蛋白水平比较存在均衡性(P>0.05);观察组治疗后白细胞介素-6(6.32±0.23)pg/ml、超敏C反应蛋白(3.13±0.57)mg/L均低于对照组的(7.18±0.52)pg/ml、(5.51±0.96)mg/L(P<0.05)。两组治疗前全血高切粘度、血小板粘附率、纤维蛋白原水平比较存在均衡性(P>0.05);观察组治疗后全血高切粘度(5.78±0.35)mPa·s、血小板粘附率(43.15±2.72)%、纤维蛋白原(3.57±0.22)g/L均低于对照组的(6.61±0.20)mPa·s、(45.37±3.19)%、(4.53±0.39)g/L(P<0.05)。两组治疗前脑源性神经营养因子、神经生长因子、氨基酸类神经递质γ-氨基丁酸水平比较存在均衡性(P>0.05);观察组治疗后脑源性神经营养因子、神经生长因子、氨基酸类神经递质γ-氨基丁酸水平均高于对照组(P<0.05)。两组治疗前语言反应、睁眼反应、肢体运动评分比较存在均衡性(P>0.05);观察组治疗后语言反应、睁眼反应、肢体运动评分分别为(4.74±0.42)、(3.49±0.21)、(5.51±0.28)分,均高于对照组的(4.09±0.46)、(2.99±0.20)、(4.89±0.53)分(P<0.05)。两组治疗前进食、洗澡、修饰、穿衣、大便控制、小便控制、用厕、床椅移动、平地行走、上下楼梯评分比较存在均衡性(P>0.05);观察组治疗后进食、洗澡、修饰、穿衣、大便控制、小便控制、用厕、床椅移动、平地行走、上下楼梯评分均高于对照组(P<0.05)。结论氯吡格雷联合阿托伐他汀钙及阿司匹林对老年急性脑梗死患者具备较好的治疗效果,其能够改善患者血液流变学及脑神经递质水平,抑制炎性因子释放,有助于提高预后。
Objective To observe the effect of clopidogrel combined with atorvastatin calcium and aspirin on the hemorheology of elderly patients with acute cerebral infarction.Methods 98 elderly patients with acute cerebral infarction were selected as the study subjects and divided into an observation group and a control group according to computer random method,with 49 cases in each group.The control group was treated with clopidogrel,and the observation group was treated with atorvastatin calcium and aspirin.Both groups were compared in terms of inflammatory factors,hemorheology indexes,brain neurotransmitter levels,brain function and daily living ability before and after treatment.Results Before treatment,the levels of interleukin-6 and hypersensitive C-reactive protein were balanced between the two groups(P>0.05).After treatment,the interleukin-6 and hypersensitive C-reactive protein of the observation group were(6.32±0.23)pg/ml and(3.13±0.57)mg/L,which were lower than(7.18±0.52)pg/ml and(5.51±0.96)mg/L in the control group(P<0.05).Before treatment,the whole blood high-shear viscosity,platelet adhesion rate and fibrinogen level were balanced between the two groups(P>0.05).After treatment,the whole blood high-shear viscosity of the observation group was(5.78±0.35)mPa·s,the platelet adhesion rate was(43.15±2.72)%,and the fibrinogen was(3.57±0.22)g/L,which were lower than(6.61±0.20)mPa·s,(45.37±3.19)%,and(4.53±0.39)g/L in the control group(P<0.05).Before treatment,the levels of brain-derived neurotrophic factor,nerve growth factor and amino acid neurotransmitterγ-aminobutyric acid were balanced between the two groups(P>0.05).After treatment,the levels of brain-derived neurotrophic factor,nerve growth factor and amino acid neurotransmitterγ-aminobutyric acid in the observation group were higher than those in the control group(P<0.05).Before treatment,the language response,eye opening response,and limb movement scores were balanced between the two groups(P>0.05).After treatment,the scores of language response,eye-opening response,and limb movement in the observation group were(4.74±0.42),(3.49±0.21),and(5.51±0.28)points,which were higher than(4.09±0.46),(2.99±0.20),and(4.89±0.53)points in the control group(P<0.05).Before treatment,the scores of eating,bathing,grooming,dressing,bowel control,urination control,toilet use,bed and chair movement,walking on flat ground,and going up and down stairs were balanced between the two groups(P>0.05).After treatment,the scores of eating,bathing,grooming,dressing,bowel control,urination control,toilet use,bed and chair movement,walking on flat ground,and going up and down stairs in the observation group were higher than those in the control group(P<0.05).Conclusion Clopidogrel combined with atorvastatin calcium and aspirin has high therapeutic efficacy in elderly patients with acute cerebral infarction,which can improve patients'hemorheology and cerebral neurotransmitter levels,inhibit the release of inflammatory factors,and help to improve prognosis.
作者
潘晓群
PAN Xiao-qun(Heze Sixth People's Hospital,Heze 274000,China)
出处
《中国实用医药》
2025年第10期92-95,共4页
China Practical Medicine
