Effect of Aspirin combined with Clopidogrel on cerebral hemodynamics and platelet parameters in patients with progressive stroke
ZENG Hai-ping1 ZHANG Han-ye2
1.The First Department of Internal Medicine,the People′s Hospital of Zijin County in Heyuan City,Guangdong Province,Zijin 517400,China;
2.ICU,the People′s Hospital of Zijin County in Heyuan City,Guangdong Province,Zijin 517400,China
Abstract：Objective To investigate the effect of Aspirin combined with Clopidogrel on cerebral hemodynamics and platelet parameters in patients with progressive stroke.Methods A total of 60 patients with progressive cerebral apoplexy treated in our hospital from January 2016 to January 2017 were selected as the research subjects.They were randomly divided into the control group(n=30)and the observation group(n=30)according to the digital table method.The control group was treated with Aspirin alone,0.1 g/times,1 times/d,and the observation group was given Clopidogrel on the basis of the control group,75 mg/times,1 times/d.The duration of treatment was 15 days in both groups.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological deficit in two groups before treatment,5 days after treatment and 2 months after treatment.Barthel Index (BI)was used to evaluate the self-care ability of the two groups of patients before and after treatment.Transcranial Doppler was used to assess the cerebral hemodynamics of two groups,including systolic peak blood flow velocity,mean blood flow velocity and pulsation indexes.The platelet inhibition rate of the two groups was detected by thrombus elastography,and platelet parameters were also detected,including platelet count(PLT),average platelet volume(MPV),platelet pressure product (PCT),platelet volume distribution width (PDW)and so on.Results The NIHSS score of 5 days after treatment and 2 months after treatment were lower than before treatment,and the BI index was higher than before treatment,the differences were statistically significant(P＜0.05).And the NIHSS scores in the observation group of 5 days after treatment and 2 months after treatment were all lower than those in the control group,the BI indexes in the observation group of 5 days after treatment and 2 months after treatment were higher than those in the control group,the differences were statistically significant(P＜0.05).There was no significant difference in hemodynamic index between the two groups before treatment(P＞0.05).While 5 days and 2 months after treatment,the systolic peak blood flow velocity and mean blood flow velocity were higher in both groups than before treatment,and the pulsation index was lower than before treatment,the differences were statistically significant(P＜0.05).And the systolic peak blood flow velocity and mean blood flow velocity in the observation group of 5 days after treatment and 2 months were higher than those in the control group,and the pulsation index in the observation group was lower than that in the control group,the differences were statistically significant(P＜0.05).After treatment,the PLT and PCT of the two groups were higher than before treatment,and MPV,PDW were lower than before treatment,the differences were statistically significant(P＜0.05).And the PLT and PCT in the observation group were higher than those in the control group,and MPV,PDW in the observation group were lower than those in the control group,the differences were statistically significant(P＜0.05).Conclusion The combination of Aspirin and Clopidogrel can effectively improve cerebral hemodynamics and platelet parameters in patients with cerebral stroke,improve neurological function deficiency,improve the therapeutic effect,improve the quality of life of patients.
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