海南医科大学学报

目的:探讨氯吡格雷与依折麦布联合治疗脑梗死效果。方法:以本院2016年1月～2018年12月间收治110例急性脑梗死患者作为研究对象,对其临床病例资料进行回顾性分析。根据不同治疗方案,分为观察组(使用氯吡格雷与依折麦布联合治疗,n=41)、对照组1(使用氯吡格雷治疗,n=39)、对照组2(使用氯吡格雷与阿托伐他汀联合治疗,n=30)。比较3组血清指标水平[叶酸(FA)、铁蛋白(ferritin)、肌钙蛋白I (cTnI)]、血脂水平[(高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)]、颈内动脉内中膜厚度(IMT)、美国国立卫生研究院脑卒中量表(NIHSS)评分、Barthel评分及疗效。结果:(1)3组治疗前血清指标水平(FA、ferritin、cTnI)、血脂水平(HDL-C、LDL-C、TC、TG)、IMT、NIHSS评分、Barthel评分比较,差异无统计学意义(P>0.05)。经过治疗后,FA、HDL-C值对照组2较对照组1更高(P<0.05),且观察组较对照组2增加明显(P<0.05),另外ferritin、cTnI、LDL-C、TC、TG、IMT水平及NIHSS评分、Barthel评分值对照组2较对照组1水平更低(P<0.05),且观察组较对照组2降低更显著(P<0.05);(2)在治疗有效率方面,观察组最高,对照组2次之,而对照组1最低(P<0.05);(3)各组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:氯吡格雷与依折麦布联合治疗脑梗死效果,能有效改善患者血脂水平,促进神经功能代谢,减少斑块形成。该方案治疗安全有效,值得推荐。

Objective: To study on the treatment efficiency of clopidogrel combined with ezetimibe in the treatment process of cerebral infarction. Methods:The 110 patients with cerebral infarction were treated in our hospital. They were considered as study objects and the clinical data were analyzed retrospectively. They were divided into observation group(n=41), control group 1(n=39) and control group 2(n=30). The patients were treated with clopidogrel combined with ezetimibe in the observation group, while the patients were treated with clopidogrel in the control group 1. Besides, the patients were treated with clopidogrel combined with atorvastatin in the control group 2. The efficacy was observed and compared among the three groups.Results:(1) Before treatment, there was no significant difference in serum index level [folic acid(FA), ferritin, cardiac troponin I(cTnI)], blood lipid level [high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), total cholesterol(TC), trilaurate glycerin(TG)], intima media thickness(IMT), national institutes of health stroke scale score(NIHSS) score, Barthel score among the three groups(P>0.05). After treatment, the FA and HDL-C values were significantly higher in the control group 2 than that in the control group 1(P<0.05), and the level in observation group was the highest(P<0.05), while the values of the ferritin, cTnI, LDL-C, TC, TG, IMT, NIHSS score and Barthel score were significantly lower in the control group 2 than those in the control group 1(P<0.05), and the level in observation group was the lowest(P<0.05).(2) The effective rate in observation group was higher than that in control group 1, and the control group 2 was between the two of them(P<0.05).(3) There was no significant difference in the incidence of adverse reactions among these three groups(P>0.05).Conclusion:Clopidogrel combined with ezetimibe is used in the treatment process of cerebral infarction, which can effectively improve the level of blood lipid, promote the metabolism of nerve function and reduce plaque formation. This scheme is safe and effective, which is worthy of recommendation.