CAJ | 학술논문

目的：探讨氯吡格雷治疗急性缺血性脑卒中的临床效果及对患者血浆大内皮素1、血清脂蛋白（a ）的影响。方法将我院于2012‐01—2014‐03收治的诊断为急性缺血性脑卒中的患者134例，按照随机数字法将患者平均为观察组67例和对照组67例，入院后2组患者均给予常规治疗，观察组患者在此基础上给予氯吡格雷片治疗，观察2组患者治疗前后big ET‐1、Lp（a）的水平变化以及治疗前与治疗后1、3、6个月时患者的神经功能缺损情况、日常生活能力以及脑血管血流速度。结果2组患者经过治疗后NIHSS评分、ADL评分、血浆big ET‐1、Lp（a）的水平均有显著降低，而VMCA显著升高，其中观察组治疗后3个月及6个月时的NIHSS评分、ADL评分及VMCA水平均有显著改善，同时显著优于对照组，而观察组经过治疗后血浆big ET‐1、Lp（a）水平也显著低于对照组，差异均具有统计学意义（P＜0.05）。结论氯吡格雷治疗急性缺血性脑卒中临床效果显著，能够显著促进神经功能恢复，改善患者的血管内皮功能，提高生活质量，同时能够显著降低患者的血浆big ET‐1、Lp（a）水平，可通过血浆big ET‐1、Lp（a）水平对患者的预后预测提供依据。
목적：탐토록필격뢰치료급성결혈성뇌졸중적림상효과급대환자혈장대내피소1、혈청지단백（a ）적영향。방법장아원우2012‐01—2014‐03수치적진단위급성결혈성뇌졸중적환자134례，안조수궤수자법장환자평균위관찰조67례화대조조67례，입원후2조환자균급여상규치료，관찰조환자재차기출상급여록필격뢰편치료，관찰2조환자치료전후big ET‐1、Lp（a）적수평변화이급치료전여치료후1、3、6개월시환자적신경공능결손정황、일상생활능력이급뇌혈관혈류속도。결과2조환자경과치료후NIHSS평분、ADL평분、혈장big ET‐1、Lp（a）적수평균유현저강저，이VMCA현저승고，기중관찰조치료후3개월급6개월시적NIHSS평분、ADL평분급VMCA수평균유현저개선，동시현저우우대조조，이관찰조경과치료후혈장big ET‐1、Lp（a）수평야현저저우대조조，차이균구유통계학의의（P＜0.05）。결론록필격뢰치료급성결혈성뇌졸중림상효과현저，능구현저촉진신경공능회복，개선환자적혈관내피공능，제고생활질량，동시능구현저강저환자적혈장big ET‐1、Lp（a）수평，가통과혈장big ET‐1、Lp（a）수평대환자적예후예측제공의거。
Objective To investigate the clinical effects of of plasma endothelin‐1 ,serum lipoprotein‐a in acute ischemic stroke treated with clopidogrel.Methods 134 patients with acute ischemic stroke in our hospital from January 2012 to March 2014 were selected and divided into the observation group and the control group according to the random number ,each group with 67 cases. The control group was given routine treatment ,the observation group received clopidogrel tablets on the basis of control group.Besides plasma big ET‐1 ,Lp (a) level ,neurological deficit ,daily life ability and cerebral blood flow velocity were detected before and after 1‐month ,3‐month ,6‐month treatment. Results After treatment ,the scores of NIHSS ,ADL and the levels of ET‐1 ,plasma big Lp(a) decreased significantly in two groups ,while VMCA increased significantly. The NIH‐SS scores ,ADL scores and VMCA levels in the observation group after 3‐month and 6‐month treatment were significantly im‐proved compared with both before treatment and the control group ,and the plasma big ET‐1 and Lp‐a levels were also signifi‐cantly lower in the observation group ,all with statistical differences (P<0.05).Conclusion Clopidogrel therapy has a signifi‐cant clinical effect on acute ischemic stroke ,which can promote the recovery of nerve function ,improve endothelial function , improve the quality of life ,and reduce the plasma big ET‐1 ,Lp(a) level which provide the evidence for predicting the progno‐sis.