摘要
目的探讨氯吡格雷对缺血性脑卒中患者血清基质金属蛋白酶(MMP)-3、8和9水平的影响及疗效观察。方法将70例缺血性脑卒中患者随机分为氯吡格雷组和对照组,每组各35例。两组患者均予以控制颅内压、血压及血糖、阿司匹林抗凝、营养脑细胞等基础治疗。氯吡格雷组加用氯吡格雷75 mg,1次/d,连用4周。对照组除不使用氯吡格雷外余同氯吡格雷组。结果治疗4周后,两组患者血清MMP-3、8和9水平[(51.16±17.15)、(19.76±5.17)、(502.64±76.41)、(38.45±17.24)、(15.24±3.07)、(384.02±65.14)μg/L]均较治疗前[(70.17±19.12)、(25.17±7.45)、(621.59±113.67)、(71.54±20.15)、(24.71±8.15)、(627.63±98.72)μg/L]明显下降(t=2.37、2.17、2.12、3.16、2.87、2.90,P<0.01或P<0.05),且氯吡格雷组下降幅度明显大于对照组(t=2.21、2.14、2.17,P<0.05);同时氯吡格雷组的临床总有效率(94.29%)明显高于对照组(71.43%)(χ2=6.44,P<0.05)。两组患者治疗期间均无明显不良反应。结论氯吡格雷治疗缺血性脑卒中具有较好的临床效果及安全性,作用机制与其降低血清MMP-3、8和9水平、抑制动脉粥样硬化的进展、稳定动脉粥样硬化斑块的作用密切相关。
Objective To discuss the effect and curative observation of Clopidogrel on serum matrix metalloproteinase（MMP）-3,8 and 9 of cerebral ischemic stroke patients.Methods 70 cases of cerebral ischemic stroke patients were selected and randomly divided into Clopidogrel group and control group,with 35 cases in each group.The patients in two groups were given basic medical treatment like the control of intracranial pressure,blood pressure,and blood sug ar,Aspirin anticoagulation and brain cells nutrition.The patients in Clopidogrel group were given Clopidogrel（75 mg） once every time daily for 4 weeks.Except for Clopidogrel,the patients in control group were given the same medical treatment as that in Clopidogrel group.Results After medical treatment for 4 weeks,serum MMP-3,8 and 9 levels of patients in two groups [（51.16±17.15）,（19.76±5.17）,（502.64±76.41）,（38.45±17.24）,（15.24±3.07）,（384.02±65.14） μg/L] declined obviously than before treatment [（70.17 ±19.12）,（25.17±7.45）,（621.59±113.67）,（71.54±20.15）,（24.71±8.15）,（627.63±98.72） μg/L]（t = 2.37,2.17,2.12,3.16,2.87,2.90,P〈0.01 or P〈0.05）,and the declining rate in Clopidogrel group was much higher than that in control group（t = 2.21,2.14,2.17,P〈0.05）;meanwhile,the total clinical efficiency in Clopidogrel group（94.29%） was much higher than that in control group（71.43%）（χ2=6.44,P〈0.05）.No untoward effect of patients in two groups appeared in the medical treatment period.Conclusion Clopidogrel has reliable and safe curative effect on the medical treatment of cerebral ischemic stroke,whose mechanism of action has close effect on lowering the serum MMP-3,8 and 9 levels,inhibiting the progress of atherosclerosis,and stabilizing the atherosclerotic plaque.
出处
《中国医药导报》
CAS
2013年第24期76-78,共3页
China Medical Herald
基金
浙江省医药卫生科技计划项目(编号2011ZHA011)
关键词
氯吡格雷
缺血性脑卒中
基质金属蛋白酶
疗效
安全性
Clopidogrel
Cerebral ischemic stroke
Matrix metalloproteinase
Curative effect
Security
