替格瑞洛联合匹伐他汀及阿司匹林治疗老年脑梗死的临床研究OA

Objective To explore the clinical efficacy and safety of aspirin enteric-coated tablets combined with ticagrelor tablets and pitavastatin calcium tablets in the treatment of cerebral infarction in the elderly.Methods Elderly patients admitted to our hospital with cerebral infarction were divided into treatment group and control group,they were given the same basic symptomatic treatment(aspirin enteric-coated tablets,etc.).The control group was treated with pitavastatin calcium tablets(oral administration,7 mg each time,once a day),while the treatment group was treated with ticagrelor tablets(90 mg each time,twice a day)combined with pitavastatin calcium tablets(oral,7 mg per time,once daily)for 3 weeks.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living scale(ADL)score,hemorheology,serum neuron-specific enolase(NSE),central nerve-specific protein(S100β),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were compared between the two groups,and safety analysis was conducted.Results A total of 102 cases were screened.There was no shedding cases were found in the two groups.Ultimately,both treatment and control groups comprised 51 cases.Following treatment,the clinical effective rates of the two groups were 90.20％(46 cases/51 cases)and 74.51％(38 cases/51 cases),respectively;the NIHSS scores were(6.61±2.19)and(11.47±3.22)points,respectively;the ADL scores were(78.25±8.02)and(70.82±7.69)points,respectively;the whole blood high shear viscosity was(4.21±0.69)and(5.86±1.13)mPa·s-1,respectively;the whole blood low shear viscosity was(8.28±2.32)and(10.74±2.83)mPa·s-1,respectively;the plasma viscosity was(1.21±0.22)and(1.66±0.34)mPa·s-1,respectively;the hematocrit was(36.28±4.75)％ and(39.62±5.08)％,respectively;the serum NSE levels were(16.57±2.92)and(23.54±3.13)μg·L-1,respectively;the serum S100β levels were(0.52±0.12)and(0.86±0.17)μg·L-1,respectively;the serum hs-CRP levels were(8.29±1.09)and(12.06±1.54)mg·L-1,respectively;the IL-6 levels were(13.47±1.55)and(19.21±2.02)ng·L-1,respectively.The levels of TNF-α were(24.23±2.56)and(30.32±3.43)ng·L-1,respectively.There were statistically significant differences between the two groups in the above indexes(all P＜0.05).The adverse drug reactions in treatment group included nausea,vomiting,indigestion,abnormal liver and kidney function;those in control group included nausea,vomiting,indigestion,arrhythmia,abnormal liver and kidney function.The overall incidence rates of adverse drug reactions were 9.80％(5 cases/51 cases)in treatment group and 7.84％(4 cases/51 cases)in control group,with no statistically significant difference(P＞0.05).Conclusion The treatment of elderly cerebral infarction with ticagrelor tablets combined with pitavastatin calcium tablets and enteric-coated aspirin tablets has a good clinical effect.It can promote the recovery of neurological function and self-care ability,improve hemorheology,reduce inflammatory response,and has good safety.