氯吡格雷、替格瑞洛联合阿司匹林治疗高血压合并脑梗死的临床疗效观察

目的比较氯吡格雷和替格瑞洛分别联合阿司匹林治疗高血压合并脑梗死的临床疗效。方法将2017年9月至2020年1月我院收治的161例高血压合并脑梗死患者随机分为氯吡格雷组(80例)和替格瑞洛组(81例)。两组患者均接受常规治疗,在此基础上,氯吡格雷组采用氯吡格雷联合阿司匹林治疗,替格瑞洛组采用替格瑞洛联合阿司匹林治疗,观察两组的临床疗效、血小板凝聚率、细胞因子与相关炎性蛋白水平及不良反应。结果治疗14 d后,替格瑞洛组的NIHSS评分、血小板凝聚率、MMP-9和Ang-Ⅱ水平低于氯吡格雷组,VEGF水平高于氯吡格雷组(P <0.05)。两组的hs-CRP、 IL-6水平以及不良反应发生率比较无统计学差异(P>0.05)。结论氯吡格雷和替格瑞洛联合阿司匹林治疗高血压合并脑梗死患者的安全性相当,但替格瑞洛联合阿司匹林的临床疗效优于氯吡格雷联合阿司匹林。

Observation on the Clinical Efficacy of Clopidogrel and Ticagrelor Combined with Aspirin in the Treatment of Hypertension Complicated with Cerebral Infarction

Objective To compare the clinical efficacy of clopidogrel and ticagrelor combined with aspirin in the treatment of hypertension complicated with cerebral infarction. Methods 161 patients with hypertension complicated with cerebral infarction in our hospital from September 2017 to January 2020 were randomly divided into clopidogrel group(80 cases) and ticagrelor group(81 cases).Both groups received routine treatment. On this basis, the clopidogrel group was treated with clopidogrel and aspirin, while the ticagrelor group was treated with ticagrelor and aspirin. The clinical efficacy, platelet aggregation rate, levels of related inflammatory proteins and cytokines and adverse reactions were observed in the two groups. Results After 14 days of treatment, compared with the clopidogrel group,the NIHSS score, platelet aggregation rate, and MMP-9 and Ang-Ⅱ levels of the ticagrelor group were lower, and the VEGF level was higher(P <0.05). No statistical difference was found in the hs-CRP and IL-6 levels and the incidence of adverse reactions between the two groups(P >0.05). Conclusions Clopidogrel and ticagrelor combined with aspirin in the treatment of hypertension complicated with cerebral infarction have equal safety, but ticagrelor combined with aspirin has better clinical efficacy than clopidogrel combined with aspirin.