CAJ | 학술논문

目的：研究氯吡格雷治疗对进展性缺血性脑卒中（ stroke in progression，SIP）患者恢复期颈部血管狭窄度、血浆纤维蛋白原（ fibrinogen，FIB）变化影响。方法选取2014年3月到2015年3月收治的SIP患者80例，按照随机数字表法将患者分为研究组和对照组，每组40例，对照组给予常规治疗，研究组在常规治疗的基础上给予氯吡格雷，应用颈动脉彩色多普勒评价颈部血管狭窄度，应用美国国立卫生研究院卒中量表（ NIHSS）和日常生活能力评分（ ADL）评价患者神经功能和生活能力，测量2组FIB和超敏C反应蛋白（ hs-CRP）水平，比较2组不良反应情况。结果治疗前2组颈总动脉、颈内动脉、颈外动脉内径宽度比较，差异无统计学意义，治疗后2组颈总动脉、颈内动脉、颈外动脉内径宽度均显著增加，且研究组宽于对照组（P＜0.05）；治疗前2组NIHSS评分和ADL评分比较无统计学意义，治疗后2组NIHSS评分和ADL评分均显著改善，且研究组优于对照组（ P＜0.05）；2组治疗前FIB和hs-CRP比较，差异无统计学意义，治疗后2组FIB和hs-CRP水平显著降低，研究组显著低于对照组（P＜0.05）；2组不良反应比较，差异无统计学意义。结论氯吡格雷治疗SIP患者恢复期能显著改善患者神经功能，改善颈部血管狭窄度，降低FIB水平。
목적：연구록필격뢰치료대진전성결혈성뇌졸중（ stroke in progression，SIP）환자회복기경부혈관협착도、혈장섬유단백원（ fibrinogen，FIB）변화영향。방법선취2014년3월도2015년3월수치적SIP환자80례，안조수궤수자표법장환자분위연구조화대조조，매조40례，대조조급여상규치료，연구조재상규치료적기출상급여록필격뢰，응용경동맥채색다보륵평개경부혈관협착도，응용미국국립위생연구원졸중량표（ NIHSS）화일상생활능력평분（ ADL）평개환자신경공능화생활능력，측량2조FIB화초민C반응단백（ hs-CRP）수평，비교2조불량반응정황。결과치료전2조경총동맥、경내동맥、경외동맥내경관도비교，차이무통계학의의，치료후2조경총동맥、경내동맥、경외동맥내경관도균현저증가，차연구조관우대조조（P＜0.05）；치료전2조NIHSS평분화ADL평분비교무통계학의의，치료후2조NIHSS평분화ADL평분균현저개선，차연구조우우대조조（ P＜0.05）；2조치료전FIB화hs-CRP비교，차이무통계학의의，치료후2조FIB화hs-CRP수평현저강저，연구조현저저우대조조（P＜0.05）；2조불량반응비교，차이무통계학의의。결론록필격뢰치료SIP환자회복기능현저개선환자신경공능，개선경부혈관협착도，강저FIB수평。
Objective To study effect of clopidogrel on neck blood vessel stenosis and plasma fibrinogen ( FIB ) in patients with stroke in progression(SIP).Methods 80 cases with SIP were selected from March 2014 to March 2015, they were divided into study group and control group according to the random number table method, 40 cases in each group, the control group was received conventional treatment, the study group was given clopidogrel on the basis of conventional treatment, evaluation of neurological function and living ability of patients with Stroke Scale (NIHSS) and daily living ability score ( ADL) , carotid artery stenosis were measured by color Doppler, the levels of FIB and C reactive protein ( hs-CRP) in two groups were also measured, adverse reactions in the two groups were compared.Results Carotid artery, internal carotid artery, external carotid artery diameter before treatment between two groups were no statistical significance,which all increased after treatment, and the study group was wider than the control group, the difference was statistically significant (P <0.05);NIHSS score and ADL score before the treatment between two groups was no statistical significance.NIHSS score and ADL score after treatment between two groups were significant improved, and the study group was better than the control group, the difference was statistically significant (P<0.05); FIB and hs-CRP before the treatment between two groups was no statistical significance, FIB and hs-CRP levels after treatment between two groups were significantly reduced, the study group was significantly lower than the control group, the difference was statistically significant (P<0.05); the adverse reactions of the two groups were not statistically significant.Conclusion Clopidogrel can significantly improve the neurological function, improve the degree of cervical vascular stenosis, reduce the level of FIB for SIP patients in recovery period.