Observation of the effect of clopidogrel combined with aspirin in the treatment of ischemic cerebrovascular disease and its influence on serum HIF-1 alpha and caspase-3

Abstract

Objective To compare the effect of clopidogrel combined with aspirin and dipyridamole combined with aspirin in the treatment of ischemic cerebrovascular disease, and to analyze its influence on the levels of serum hypoxia-inducible factor 1 alpha(HIF-1 alpha), cysteine proteinase 3(caspase-3). Methods 96 patients with ischemic cerebrovascular disease were selected, and they were randomly divided into A group(n=48) and B group(n=48) according to the digital table.A group was treated with clopidogrel and aspirin, B group was treated with dipyridamole and aspirin.The clinical efficacy, adverse reactions and serum HIF-1 alpha, caspase-3 expression before and after treatment were compared between the two groups. Results The total effective rate of A group was 93.8%, which was significantly higher than 83.3% of B group (χ2=12.760, P 0.05). After 4 weeks of treatment, the MESSS score of A group was (5.07±1.26)points, which of B group was (6.12±1.48)points, the MESSS scores of the two groups were decreased significantly than those before treatment, and the MESSS score of A group after treatment was significantly lower than that of B group(t=7.306, P 0.05). After 4 weeks of treatment, the levels of HIF-1 and caspase-3 in A group were (248.55±12.44)ng/mL, (7.34±1.77)ng/mL, respectively, which in B group were (301.63±14.86)ng/mL, (8.85±1.94)ng/mL, respectively.The levels of HIF-1 alpha and caspase-3 levels in A group were significantly lower than those in B group (t=8.778, 9.156, all P<0.05). The incidence rate of adverse reaction of A group was 4.2%, which was significantly lower than 10.4% of B group(χ2=8.461, P<0.05). Conclusion Compared with dipyridamole combined with aspirin, clopidogrel combined with aspirin in the treatment of ischemic cerebrovascular disease can effectively improve the patients' neurological impairment, inhibit the expression of serum HIF-1, caspase-3, with less adverse reaction, and it is worthy of application and promotion. Key words: Cerebrovascular disorders; Clopidogrel; Aspirin; Hypoxia-inducible factor 1; Cysteine Proteases