Objective  To investigate the efficacy and safety of different doses of clopidogrel in the treatment of patients with acute cerebral infarction (CI).

  Methods  Totally 86 hospitalized patients with acute CI were randomly divided into high dose group (n=43) and low dose group (n=43). On the basis of routine symptomatic treatment, the high dose group was treated with 150 mg clopidogrel, while the small dose group was treated with 5 mg clopidogrel. All patients were treated for 3 months. The platelet count, platelet aggregation rate, score of National Institute of Health Stroke Scale (NIHSS) before and after treatment as well as adverse events were compared between two groups.

  Results  The platelet count, platelet aggregation rate and NIHSS score in the high dose group were significantly lower than those in the low dose group (P < 0.05). The short-term recurrence rate of cerebral infarction was 2.33% in high dose group and 9.30% in low dose group, and the incidence rate of bleeding was 11.63% in high dose group and 4.65% in low dose group, and all these results showed no significant differences (P>0.05). The deterioration rate of neurological function in high dose group was 4.65%, which was significantly lower than 18.60% in low dose group (P < 0.05).

  Conclusion  Compared with the standard dose of 75 mg clopidogrel, the high dose of 150 mg clopidogrel has better anti-platelet aggregation effect, which can effectively promote the recovery of neurological function in CI patients.