摘要
目的:探究氯吡格雷联合阿司匹林(ASP)对急性脑梗死(ACI)患者机体血清高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子相关蛋白3(CTRP3)水平的影响.方法:回顾我院90例ACI患者(2022年1月-2023年12月)资料,按治疗方案不同分成A组(n=45)、B组(n=45).A组接受氯吡格雷联合ASP治疗,B组接受ASP治疗.对比2组总有效率、治疗前后美国国立卫生研究院卒中量表(NIHSS)、蒙特利尔认知评估量表(MoCA)评分、血液流变学[全血低切黏度(LBV)、全血中切黏度(WBV)、全血高切黏度(HBV)、血浆黏度(PV)]、神经损伤因子[神经元特异性烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)、中枢神经特异蛋白(S-100β)]、血清hs-CRP、IL-6、CTRP3水平、不良反应发生率.结果:A组总有效率93.33％(42/45)较B组75.56％(34/45)显著增高(P＜0.05);治疗14d后A组NIHSS评分较B组低,MoCA评分较B组高(P＜0.05);治疗14d后A组LBV、WBV、HBV、PV水平较B组低(P＜0.05);治疗14 d后A组血清NSE、MMP-9、S-100β水平较B组低(P＜0.05);治疗14d后A组血清hs-CRP、IL-6水平较B组低,血清CTRP3水平较B组高(P＜0.05);2组不良反应发生率相比无明显差异(P＞0.05).结论:氯吡格雷联合ASP治疗ACI患者效果显著,可有效缓解机体炎性状态,减轻神经损伤,调节血流流变学水平,改善神经及认知功能,且具有较高用药安全性.
Abstract
Objective:To investigate the effect of clopidogrel combined with aspirin(ASP)on serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumour necrosis factor-related protein 3(CTRP3)levels in patients with acute cerebral infarction(ACI).Methods:-90 ACI patients were collected(from January 2022 to December 2023)in our hospital and divided into group A(n=45)and group B(n=45)according to treatment regimen.Group B received ASP treatment,while group A received clopidogrel combined with ASP treatment.Compare the total effective rate and levels of the National Institutes of Health Stroke Scale(NIHSS),Montreal Cognitive Assessment Scale(MoCA),hemorheology[whole blood low cut viscosity(LBV),whole blood mid cut viscosity(WBV),whole blood high cut viscosity(HBV),plasma viscosity(PV)],nerve injury factors[neuron-specific enolase(NSE),matrix metalloproteinase-9(MMP-9),central nervous system-specific protein(S-100β)],serum high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor associated protein 3(CTRP3)before and after treatment between the two groups,as well as the incidence of adverse reactions during treatment.Results:The total effective rate of group A was 93.33％(42/45)higher than group B 75.56％(34/45)(P＜0.05);NIHSS score was lower and MoCA score was higher in group A than in group B after 14 d of treatment(P＜0.05);LBV,WBV,HBV,PV levels were lower in group A than in group B after 14 d of treatment(P＜0.05);Serum NSE,MMP-9,S-100β expression was lower in group A than in group B after 14 d of treatment(P＜0.05).The expression of serum NSE,MMP-9 and S-100β in group A was lower than that in group B after 14 d of treatment(P＜0.05);After 14 days of treatment,the serum levels of hs CRP and IL-6 in group A were lower than those in group B,while the serum levels of CTRP3 were higher than those in group B(P＜0.05);There was no significant difference in the incidence of adverse reactions between the 2 groups compared with each other(P＞0.05).Conclusion:The combination of clopidogrel and ASP has a significant effect on treating ACI patients,which can effectively alleviate the inflammatory state of the body,reduce nerve damage,regulate blood theology levels,improve neurological and cognitive functions,and has high drug safety.
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