目的 探討頸動(dòng)脈重度狹窄患者支架成形術(shù)后氯吡格雷對(duì)其血小板功能及炎癥因子的影響。方法 選取120例經(jīng)頸動(dòng)脈支架成形術(shù)治療的頸動(dòng)脈重度狹窄患者，隨機(jī)分為兩組，對(duì)照組應(yīng)用阿司匹林聯(lián)合阿托伐他汀，觀察組應(yīng)用氯呲格雷聯(lián)合阿托伐他汀，術(shù)前使用3～5 d，術(shù)后均連續(xù)服用3個(gè)月。觀察用藥后血清D-二聚體（DD）水平、纖維蛋白原（FIB）水平、炎癥因子P-選擇素水平以及再狹窄事件的發(fā)生率。結(jié)果 術(shù)前，兩組DD及FIB水平無(wú)顯著差異；術(shù)后24 h，對(duì)照組及觀察組DD及FIB水平均明顯升高（P<0.05）。術(shù)后1個(gè)月，兩組DD及FIB水平均明顯下降，但仍明顯高于術(shù)前（P<0.05）。術(shù)后3個(gè)月，DD及FIB水平和術(shù)前相比，無(wú)顯著差異，DD及FIB水平均在正常范圍內(nèi)。術(shù)后24 h、1個(gè)月、3個(gè)月，觀察組DD及FIB水平均明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。術(shù)前，兩組的P-選擇素對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義，術(shù)后均明顯下降，且觀察組低于對(duì)照組（P<0.05）；觀察組的再狹窄事件的發(fā)生率均低于對(duì)照組（P<0.05）。結(jié)論 氯吡格雷聯(lián)合阿托伐他汀可抑制重度頸動(dòng)脈狹窄患者術(shù)后血小板聚集預(yù)防血栓形成，降低再狹窄事件的發(fā)生率，同時(shí)可抑制炎癥因子P-選擇素的表達(dá)預(yù)防動(dòng)脈粥樣硬化。

Objective To investigate the effect of clopidogrel on platelet function and inflammation factor in treatment of severe carotid artery stenosis after stent-assisted angioplasty.Methods Patients (120 cases) with severe carotid artery stenosis after stent-assisted angobservation group were given atorvastatin combined with chlorine. The serum coagulants DD level, FIB level, inflammation factor P-chosen element level and restenosis event incidence of two groups were observed.Results D-double polymer of two groups had no significant difference; After surgery, the D-double polymer and FIB level of two groups were all higher (P<0.05). After surgery for 24 h, the D-double polymer and FIB level of observation group were higher, after 3 months of surgery, the D-double polymer and FIB level had no significant differences compared with before surgery, which were all in normal level. After 24 h, 1 month, 3 months of surgery, the D-double polymer and FIB level of observation group were all lower than control group (P<0.05). Before treatment, the P-chosen selectin of two groups had no significant differences, which were all decreased after surgery, and the observation group was lower than control group (P<0.05); The restenosis event of observation group was lower than control group (P<0.05).Conclusion Clopidogrel could control the platelet aggregation of severe carotid stenosis after surgery to prevent the thrombogenesis and decrease the restriction incidence, while control the inflammation factor expression to prevent the atherosclerosis.