Clinical Effect Of Dual Anti-platelet Therapy Between Microemboli Positive And Negative Acute Cerebral Infarction

Objective To investigate the difference in the clinical efficacy of aspirin combined with clopidogrel in patients with microemboli signals(MES)positive and negative acute cerebral infarction.Method One hundred patients with acute non-cardiogenic cerebral infarction were admitted to our hospital from July 2017 to December 2018,including 50 cases were positive for MES and 50 cases were negative for MES.Double anti-platelet therapy was given(300mg of clopidogrel on day 1 followed by 75 mg per day for 90 days;100mg of aspirin on day 1 to day 21,discontinued aspirin after day 21;both groups had basic treatment).The degree of neurological deficit and drug efficacy was evaluated by National Institutes of Health Stroke Scale(NIHSS)before treatment,in 7d,14 d and the third month after treatment;The number of microemboli changes was monitored by TCD;Daily living skills assessment were assessed by modified Rankin score(m RS)before treatment and 3 months after treatment.At the same time,the adverse reactions of the two groups of patients after treatment were recorded.Results The NIHSS scores of two groups in 3 months after treatment were lower than those before treatment.The NIHSS scores of the microemboli positive group were significantly lower than those of the negative group(P<0.05),there was no significant difference in the total efficiency rate between two groups.After 3 months of treatment,the m RS scores of the two groups were significantly lower than before treatment,and the microemboli positive group was significantly lower than the negative group(P<0.05).The number of microemboli in the microemboli positive group in 14 and 3 months after treatment was significantly lower than that before treatment(P<0.05).There was no significant difference in the incidence of adverse events between the two groups during treatment and follow-up(P>0.05).Conclusion Micro-emboli positive patients with aspirin combined with clopidogrel dual antiplatelet therapy can significantly reduce the number of micro-emboli,and it also can improve their long-dated neurological function and the activity of daily living as well as enhancing their quality of life.