The Clinical Efficacy of Clopidogrel Bisulfate Tablets Combined with Olmesartan Medoxomil for Ischemic Stroke with Hypertension and the Effect of Angiotensin II Type 1 Receptor Level on Prognosis

氯吡格雷硫酸氢盐片联合奥美沙坦酯治疗高血压合并缺血性卒中的临床疗效及血管紧张素II 1型受体水平对预后的影响

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Abstract

BACKGROUND: Ischemic stroke combined with hypertension can increase risks of stroke recurrence and death. AIM: The aim of this study is to investigate the clinical efficacy of clopidogrel bisulfate tablets combined with olmesartan medoxomil in the treatment of ischemic stroke patients with hypertension and the effect of angiotensin II type 1 receptor (AT(1)R) level on prognosis. METHODS: Ninety ischemic stroke patients with hypertension were chosen for continuous treatment with clopidogrel bisulfate tablets and olmesartan medoxomil for 12 months. The Modified Edinburgh Scandinavian Stroke Scale (MESSS) score, Brunnstrom score, Barthel score, death, recurrence, and progression of cerebrovascular residual lesions were observed and recorded during the treatment period. According to the plasma AT(1)R expression of the patients before treatment, the patients were divided into a high-AT(1)R group and low-AT(1)R group. Then, survival analysis was performed. RESULTS: Compared with pretreatment, the MESSS scores of the patients at the first, second, third, sixth, ninth, and twelfth months after treatment were reduced (p < 0.01) while the Brunnstrom score and Barthel score were prominently boosted (p < 0.01). Compared with the low-AT(1)R group, patients in the high-AT(1)R group had higher rates of stroke recurrence and progression of residual cerebrovascular lesions (p < 0.05). CONCLUSION: Clopidogrel bisulfate tablets combined with olmesartan medoxomil has prominent clinical effects in the treatment of ischemic stroke patients with hypertension, evidently improving the prognosis. In addition, the level of AT(1)R may be a vital factor affecting the prognosis.

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