Chinese Journal of Contemporary Neurology and Neurosurgery (Oct 2013)
Evaluation of therapeutic efficacy on combined use of clopidogrel and ozagrel sodium in the treatment of acute ischemic stroke
Abstract
Background Antiplatelet aggregation treatment has become a regular treatment of ischemic stroke. The affirmation of antiplatelet therapy is mainly derived from patients with clinical use, which can not provide the laboratory indexes for evaluation of a recognized accuracy. Studies have confirmed that the degree of platelet activation is associated with atherosclerosis and ischemic stroke, and recognized that both CD62p (α-platelet granule membrane glycoprotein) and CD63 (lysosomal membrane glycoprotein) were important indexes of platelet activation. This study aims to explore the differences of efficacy between combined use of clopidogrel and ozagrel sodium and monotherapy by aspirin in the treatment of acute ischemic stroke by investigating the expression of CD62p and CD63. Methods Flow cytometry was employed to detect CD62p and CD63 expression on circulating platelet in patients with ischemic stroke and normal control group. The positive rate of CD62p and CD63 was detected in patients with ischemic stroke who were treated with aspirin 0.15 g (single drug therapy) and clopidogrel 75 mg + ozagrel sodium 80 mg (combination therapy) before and after one and two weeks' treatment. National Institute of Health Stroke Scale (NIHSS) scores were measured in patients with ischemic stroke at the same time in three periods respectively to evaluate the improvement of neural function. Results Platelet CD62p and CD63 positive expression rate in ischemic stroke group were higher than normal control group before treatment (P = 0.001, 0.032). CD62p and CD63 positive expression rate and NIHSS score were measured at different times, and the differences were statistically significant (F = 56.693, P = 0.000; F = 21.544, P = 0.000; F = 216.271, P = 0.000, respectively). Compared with before treatment, CD62p and CD63 positive expression rate and NIHSS score decreased significantly after treatment (P = 0.000, for all), but the differences between aspirin group and combination group were not statistically significant (P > 0.05, for all). There was no interaction between the treatment groups and measuring time with CD62p and CD63 positive expression rate (F = 1.403, P = 0.250; F = 2.830, P = 0.063), while there was interaction between treatment groups and measuring time with NIHSS score (F = 4.518, P = 0.013). Conclusion Antiplatelet drug treatment of acute ischemic stroke is effective. The curative effect of combined treatment (clopidogrel and ozagrel sodium) is not superior to aspirin alone. CD62p positive expression rate in acute stage of ischemic stroke can measure the effect of antiplatelet therapy, while the determination of CD63 needs further research.
