Comparison Of Efficacy Between Two Treatment Regimens For Patients With Acute Pawn

Objectives To discuss the effect of ticagrelor and clopidogrel in acute light platelet parameters of patients with ischemic stroke and the influence of the curative effect of inhibiting platelet aggregation,and compare the two drugs through follow-up the incidence of adverse events in patients with acute light of ischemic stroke and security.Methods This study uses the prospectie,double-blind,randomized,controlled study,100 cases are selected in November 2015 to March 2017 in the north China university of science and technology affiliated hospital nerve within two branch and nerve within four division to the light of acute ischemic stroke patients,69 cases of male and female 31 cases,the average age was 61.19±7.68 years old.In accordance with the standards in front and back were randomly divided into ticagrelor group and clopidogrel group,the ticagrelor group to use for ticagrelor with aspirin therapy,a total of 51 cases,clopidogrel group for the use of clopidogrel in combination with aspirin treatment,a total of 49 cases,On the first day of the ticagrelor group,180 mg of ticagrelor and 100 mg of aspirin were taken,the second day was taken for ticagrelor 90 mg 2/ day and aspirin 100mg/ day.The clopidogrel group was treated with clopidogrel 300 mg and aspirin 100 mg for the first day,and clopidogrel 75mg/ day and aspirin 100mg/ day for the second day,and 7-9 days for observation period,to compare the inhibition of platelet aggregation in 2 hours,24 hours,7-9 days before and after treatment.Comparing the two groups before treatment and 7-9days platelet maximum aggregation rate,platelet parameters change,the nerve function defect situation,and through six months of follow-up statistics the incidence of adverse events and bleeding events.Results 1 There was no significant difference between the ticagrelor group and the clopidogrel group ADP compared with the control group(3.37±6.02%VS1.92±4.83%,P>0.05).The platelet inhibition rate was significantly higher in the ticagrelor group than in the clopidogrel group after 2 hours,24 hours,7-9 days(75.04±29.73%VS13.86±19.17%,83.04±20.55%VS25.29±22.93%,80.78±22.77%VS33.63±24.75%,P=0.000).The maximum aggregation rate of platelets in the ticagrelor group and the clopidogrel group,ADP pathway and AA pathway,was decreased after 7-9 days(P=0.000),and the decrease of the ticagrelor group was greater than that of the clopidogrel group.Platelet count and platelet average volume were not statistically significant between the two groups(P>0.05).The NIHSS score and m RS score were compared between the ticagrelor group and the clopidogrel group after 7-9 days,and the ticagrelor group was lower than the clopidogrel group,indicating that the recovery of the ticagrelor group was better than that of the clopidogrel group(1.63±1.06VS2.22±1.72,P=0.041;0.94±0.65VS1.31±0.94,P=0.027).Compared with the clopidogrel group in progress of stroke,the ticagrelor group was significantly lower than the clopidogrel group(3.92%VS18.36%P=0.021).In the ticagrelor group,the incidence of new infarction,chest tightness,dizziness,headache,skin itching,stomach discomfort and other conditions in the clopidogrel group was not statistically significant compared with those in the clopidogrel group(3.92%VS8.16%,9.80%VS6.12%,11.76%VS10.2%,7.84%VS4.08%,3.92%VS4.08%,5.88%VS14.29%,P>0.05).During the follow-up period,no severe bleeding or moderate bleeding was observed in the two groups according to the blood grading standard(GUSTO),and there was no significant difference in the total bleeding incidence between the ticagrelor group and the clopidogrel group(17.64%VS14.29%,P=0.647).Conclusions 1 For the patients in the pawn,the combination of ticagrelor and aspirin has better platelet function inhibition effect than clopidogrel,and the effect is more rapid.2 The combination of clopidogrel and aspirin with ticagrelor and aspirin had no significant effect on platelet count and platelet average volume.3 During the observation period(7-9 days),the prognosis of patients with ticagrelor combined aspirin therapy was better than that of clopidogrel combined with aspirin.4 The treatment of ticagrelor combined with aspirin reduced the incidence of major adverse events and did not increase the risk of bleeding.