| Background and purpose:Cerebral infarction is high incidence and recurrence of adisease,which seriously affect the patent’s quality of life. The risk ofischemic stroke recurrence is highest nearly10%in the first year since itonset, and then5%each year. In such a high recurrence of case,secondary prevention to prevent stroke is a critical treatment priority. Atpresent, there is no evidence that the better antiplatelet drugs in thetreatment and prevention of recurrent stroke.The trial was aimed to compare the relative efficacy and safety ofdifferent doses clopidogrel with that of aspirin among patients who had arecent ischemic stroke The evaluation indexes including: neurologicimpairment score, the incidence of adverse drug reactions, strokerecurrence, then investigating the clinical significance of the aboveindexes changes.Methods:136Acute ischemic stroke patients were randomized divided into3groups:clopidogrel-100mg group, clopidogrel-50mg group andaspirin-100mg group. All given the same basic treatment: Blood clotstong injection, Muscle ammonia peptide glycosides injection, Mr ozagrel sodium injection. And symptomatic treatment conteined hypertensiondiabetes hyperlipidemia, high homocysteine levels. Clopidogrel-100mggroup was given based on the use of above drugs and clopidogrel100mg;clopidogrel-50mg group was given clopidogrel50mg; aspirin-100mg group was given aspirin100mg.3groups were administeredneurologic impairment score at the onset,2weeks,1month,3months,6months. Adverse drug reactions and the occurrence of strokewas observed during the follow-up period.Results:13groups of patients on admission and comparing two neuralfunction defect scale has no statistical significance (P>0.05).At2weeksand3months, neurologic impairment score of3groups were reducedcompared with that on admission. Clopidogrel-100mg group than50mgand aspirin-100mg group decreased obviously, with statisticalsignificance (P<0.05). Clopidogrel-50mg group down significantly,compared with aspirin-100mg group, but without statistical significance(P>0.05).At3months and6months,3groups of patients with nervefunction defect score lower than before, clopidogrel-100mg groupcompared with clopidogrel-50mg and aspirin-100mg group decreasedobviously, with statistical significance(P<0.05). Clopidogrel-50mg groupwith neural function defect scale reduced significantly compared with thatof aspirin-100mg group, but without statistical significance (P>0.05). 2During the observation’s period, the incidence of adverse drugreactions of the three groups’ patients are:clopidogrel-100mg group is19.2%, clopidogrel-50mg group is5.3%,aspirin-100mg group is26.7%.The rate of adverse drug reaction is19.2%of patients inclopidogrel-100mg group, as compared with5.3%of those in theclopidogrel-50group (P>0.05).The rate of adverse drug reaction is26.7%of patients in aspirin-100mg group, as compared with19.2of those in theclopidogrel-100mg group (P>0.05);as compared with5.3%of those in theclopidogrel-50mg group (P<0.05).3Follow-up period, the incidence of stroke recurrence in the threegroups of patients are:clopidogrel-100mg group5.8%,clopidogrel-50mggroup7.9%,aspirin-100mg group24.4. The rate of stroke recurrence is5.8%of patients in clopidogrel-100mg group, as compared with7.9%ofthose in the clopidogrel-50mg group (P>0.05). The incidence of strokerecurrence is24.4%of patients in the aspirin-100mg group, as comparedwith5.8%of those in the clopidogrel-100mg group (P<0.05);as comparedwith7.9%of those in the clopidogrel-50mg group (P<0.05).Conclusion:1. In patients with cerebral infarction who can be treated within3days after the onset of symptoms, the clopidogrel is superior to aspirin forreducing neurologic impairment score in2weeks times.2. In the treatment of acute cerebral infarction,100mg dose of clopidogrel in better than50mg dose of that and100mg dose of aspirin.3. The50mg dose of clopidogrel is superior to100mg in theprevention of stroke recurrence and the former does not increase the riskof adverse drug reaction. |
PDF Full Text Request