OBJECTIVE: To systematically evaluate the effects of clopidogrel combined with atorvastatin on inflammation response

hemorheology and blood coagulation in patients with cerebral infarction

so as to provide reference for better guidance of clinical medication. METHODS: PubMed

the Cochrane Library

Embase

CBM

CNKI

VIP and Wanfang Data were retrieved to collect the randomized controlled trials（RCT） of clopidogrel combined with atorvastatin in the treatment of cerebral infarction（the control group was treated with clopidogrel or clopidogrel + conventional treatment

while the research group received atorvastatin on the basis of the control group）

the retrieval time was from the establishment of the database to Nov. 2021. RevMan 5.4.1 software was used for Meta-analysis and bias risk assessment

and GRADE system was used for evidence quality assessment grading. RESULTS: Totally 24 articles were collected

including 1 107 patients in the research group and 1 106 patients in the control group. Meta-analysis showed that hypersensitive C-reactive protein（MD=-3.25

95%CI=-3.77--2.73

P<0.000 01）

tumor necrosis factor α（SMD=-1.31

95%CI=-1.51--1.11

P<0.000 01）

plasma viscosity（MD=-0.42

95%CI=-0.60--0.24

P<0.000 01）

erythrocyte aggregation index（MD=-0.82

95%CI=-1.37--0.26

P=0.004）

fibrinogen（MD=-0.99

95%CI=-1.85--0.12

P=0.03）

D-dimer（SMD=-2.38

95%CI=-3.52--1.24

P<0.000 01） and prothrombin time（MD=1.92

95%CI=1.22-2.62

P<0.000 01） in the research group were significantly better than those in the control group

with statistically significant differences. There was no significant difference in hematocrit between two groups（SMD=-0.33

95%CI=-1.09-0.42

P=0.38） and activated partial prothrombin time（MD=1.22

95%CI=-1.81-4.26

P=0.43）. Systematic evaluation of GRADE showed that the level of evidence was low or very low quality

and the recommendation strength was weak. CONCLUSIONS: Current evidence suggests that clopidogrel combined with atorvastatin can reduce inflammation response and improve hemorheology and blood coagulation in patients with cerebral infarction. Due to the low level of evidence in the included studies

the above results have certain limitations

and more high-quality and high-standard studies are still needed for further demonstration.