阿斯匹林联合氯吡格雷治疗脑梗死对血小板功能和预后的影响

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Abstract Objective: To evaluate the effects of clopidogrel combined with aspirin compared to aspirin alone on platelet function and short-term outcome in patients with acute large-artery atherosclerosis stroke. Methods: Altogether 570 patients with acute (≤72 h) atherosclerotic cerebral infarction were randomly assigned to receive combined clopidogrel with aspirin and aspirin alone. Platelet aggregation and platelet-leukocyte aggregation were detected at day 1 and day 30. Primary outcome was neurological deterioration, second outcomes including recurrent ischemic stroke, periphery vascular events, myocardial infarction and all cause deaths. Safety endpoints were hemorrhagic episodes and death in 30 days. Results: Patients who received the combination therapy had significantly fewer ischemic stroke recurrence events and neurological deterioration than those given monotherapy. At day 30 of treatment, the platelet aggregations and platelet-leukocyte aggregation were lower than those patients given aspirin alone (P<0.01). Compared to patients who did not suffer neurological deterioration or recurrent stroke, the platelet aggregation induced by arachidonic acid or ADP, and platelet-leukocyte aggregation, at day 1 were higher than those patients who did experience these afflictions (P<0.01). Conclusion: Treatment with combined clopidogrel and aspirin provides significantly greater inhibition of platelet activity than did aspirin alone, and appears to be safer and more effective in reducing ischemic stroke recurrence and neurological deterioration.

Key words： acute ischemic stroke recurrent ischemic stroke antiplatelet therapy platelet function neurological deterioration

Received: 18 April 2014

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	CHI Wanzhang1
	ZHOU Qiang1
	LIN Jing1
	YI Xingyang2.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I4/273

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