氯吡格雷联合阿司匹林治疗2型糖尿病并发急性脑梗死患者的临床疗效

doi:10.3969/j.issn.1671-7171.2020.03.028

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摘要【目的】探讨氯吡格雷联合阿司匹林治疗2型糖尿病(T2DM)并发急性脑梗死患者的临床疗效。【方法】回顾性2016年8月至2018年10月在本院诊治的82例T2DM并发急性脑梗死患者,按照治疗方法不同分为观察组和对照组。对照组采用常规阿司匹林治疗,观察组在对照组的基础上加用氯吡格雷治疗,分析两组患者临床疗效。【结果】两组患者治疗前空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、血管紧张素-Ⅱ(Ang-Ⅱ)、平均血小板体积(MPV)、大血小板比例(P-LCR)水平、颈动脉内膜-中层厚度(IMT)、斑块数量、斑块面积比较差异无统计学意义(P>0.05);治疗后,观察组患者FPG、2hPG、HbAlc、MMP-9、Ang-Ⅱ、MPV、P-LCR水平、颈动脉IMT、斑块数量、斑块面积显著低于对照组,VEGF水平显著高于对照组(P<0.05)。两组患者治疗前美国国立卫生院神经功能缺损(NIHSS)评分比较差异无统计学意义(P>0.05);治疗后6 d、12 d,观察组患者NIHSS评分显著低于对照组(P<0.05)。【结论】氯吡格雷联合阿司匹林治疗T2DM并发急性脑梗死,可有效改善患者血糖和神经功能,值得临床推广应用。

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	王可
	汪洋

关键词 ：糖尿病, 2型/并发症, 糖尿病, 2型/药物疗法, 脑梗塞/药物疗法

Abstract：【Objective】To investigate the clinical effect of clopidogrel combined with aspirin in patients of type 2 diabetes mellitus (T2DM) with acute cerebral infarction. 【Methods】Retrospectively, a total of 82 patients with T2DM complicated with acute cerebral infarction from August 2016 to October 2018 in our hospital were divided into the observation group and the control group according to the treatment methods. Patients in the control group received conventional aspirin, while those in the observation group received clopidogrel and aspirin. The clinical effects of the two groups after treatment were analyzed. 【Results】The fasting blood glucose (FPG), postprandial 2h blood glucose (2hPG), glycosylated hemoglobin (HbA1c), vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), angiotensin-ii (Ang-Ⅱ), mean platelet volume (MPV), large platelet ratio (P-LCR) level, carotid intima-media thickness (IMT), plaque number and plaque area between the two groups were not statistically significant (P>0.05). After treatment, the levels of FPG,2hPG, HbAlc, MMP-9,Ang-II,MPV,P-LCR,IMT,plaque number and area in the observation were lower than those in the control group (P<0.05), while VEGF level in the observation group was higher than that in the control group (P<0.05). Before treatment, there was no significant difference in the scores of neurological impairment (NIHSS) between the two groups (P>0.05), however, the scores of NIHSS in the observation group at 6 and 12 days after treatment were significantly lower than those in the control group (P<0.05). 【Conclusion】Clopidogrel combined with aspirin in the treatment of T2DM with acute cerebral infarction can effectively improve the status of blood glucose and nerve function of patients, which is worthy of clinical application.

Key words： Diabetes Mellitus Type 2/CO Diabetes Mellitus Type 2/DT Brain Infarction/DT

收稿日期: 2019-02-21

PACS:

R587.1

通讯作者: **, E-mail: 422257925@qq.com

引用本文:

王可, 汪洋. 氯吡格雷联合阿司匹林治疗2型糖尿病并发急性脑梗死患者的临床疗效[J]. 医学临床研究, 2020, 37(3): 415-418.
WANG Ke, WANG Yang. Clinical Effects of Clopidogrel Combined with Aspirin in Patients with Type 2 Diabetes Complicated with Acute Cerebral Infarction. JOURNAL OF CLINICAL RESEARCH, 2020, 37(3): 415-418.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.03.028 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I3/415

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