Efficacy And Safety Of Aspirin Combined With Clopidogrel In The Treatment Of Patients With Acute Cerebral Infarction

ObjectiveBy observing the patients with acute non cardiac cerebral infarction using antiplatelet drugs before and after treatment of the national institutes of health stroke scale(NIHSS)score,serum hypersensitive c-reactive protein(hs-CRP)level and the change of the modified Rankin scale(mRS)score and were followed up for 6 months after the NIHSS and mRS score differences,to explore the application of both kinds of antiplatelet agents(aspirin and clopidogrel)whether can better inhibit thrombosis,prevent blood clots progress,to reduce the infarction area inflammation levels,Whether to increase the risk of bleeding and whether to reduce the degree of neurological impairment of patients,and through follow-up,to observe whether the long-term neurological recovery after the application of dual antiplatelet drugs is beneficial,in order to help guide the drug treatment of patients with non-cardiac cerebral infarction.MethodA total of 200 patients with acute non-cardiac cerebral infarction admitted to the department of neurology of the second affiliated hospital of shenyang medical college from October 2018 to October 2019 were randomly divided into the observation group(n = 100)and the control group(n = 100).All patients were given treatment to improve circulation and nourish brain cells.Observation group with dual antiplatelet therapy(on the day of admission to clopidogrel 300 mg orally,then to 75 mg a day,at the same time to aspirin daily 100 mg of clothing,21 d after treatment,instruct patients discontinued aspirin,continue to oral clopidogrel 75 mg a day to experiment on 90 d,then according to the situation of patients with gastrointestinal reaction and economic condition,choose to continue taking either clopidogrel orally at 75mg/day or aspirin at100mg/day for a total of 180 days).The control group received single antiplatelettherapy(aspirin 100 mg daily,continuous application 180d).The follow-up time point was 6 months after the onset of the disease.Gender and age of all participants were recorded,and general clinical baseline data including weight(kg),height(cm),previous disease history,drinking history,smoking history and biochemical indicators such as blood lipid were measured.Hs-crp level,NIHSS score and mRS score of all patients were recorded on the day of admission and 14 d after treatment.Intracranial hemorrhage events occurred within 7 days of treatment in both groups were recorded.After 6 months of follow-up,all observers were again given NIHSS and mRS scores,and the gastrointestinal,nasal and gingival bleeding events occurred in all observers during this period were recorded.Data analysis SPSS24.0 software was used to compare the general information of patients in the two groups,mRS score,NIHSS score and hs-crp level before and after treatment,as well as bleeding events during treatment in the two groups.Results1.There was no statistically significant difference between the two groups in baseline data such as weight,age,and related disease history(P>0.05).2.There was no statistically significant difference in serum hs-crp level,NIHSS score and mRS score between the observation group and the control group before treatment(P>0.05).3.The serum hs-crp level of patients in the observation group and the control group was lower on 14 d after treatment than before treatment,and the difference was statistically significant(P<0.05).4.The mRS score and NIHSS score of the two groups on 14 d and 180 d after treatment were lower than that before treatment,and the NIHSS score and mRS score on 180 d after treatment were lower than that on 14 d after treatment,with statistically significant differences(P<0.05).5.On the 14 d after treatment,the serum hs-crp level of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).6.At 14 d and 180 d after treatment,NIHSS score and mRS score of the observation group were lower than those of the control group,with statistically significantdifferences(P<0.05).7.Within 7 days of treatment,no intracranial hemorrhage events occurred in the two groups,with no statistical difference(P>0.05).8.Within 180 days of treatment,there was no statistically significant difference in the incidence of gastrointestinal,nasal and gingival bleeding between the two groups(P>0.05).ConclusionsTo inhibit thrombogenesis,progression and infarction area expansion,reduce the level of inflammation in the infarct area and improve the neurological function in patients without cardiac cerebral infarction,combined use of aspirin and clopidogrel has a better effect than that of aspirin alone,and the six-month benefit has been very clear.Moreover,this study found that the double-antibody therapy did not increase the bleeding transformation of patients,indicating that the double-antibody therapy is consistent with the monoclonal antibody in terms of safety,and can be promoted as a safe and effective treatment.