氯吡格雷联合阿司匹林治疗老年短暂性脑缺血发作的临床观察

发布时间：2018-07-10 15:01

本文选题：氯吡格雷 + 阿司匹林　；参考：《中国药房》2016年27期

【摘要】：目的:观察氯吡格雷联合阿司匹林治疗老年短暂性脑缺血发作的疗效和安全性。方法:90例短暂性脑缺血发作老年患者随机分为观察组(50例)和对照组(40例)。两组患者均予以缺血性脑卒中患者常规治疗,包括他汀类药物、低分子右旋糖酐、尿激酶等药物,对于合并其他基础疾病者给予对症治疗。在此基础上,对照组患者口服阿司匹林肠溶片100 mg,每日1次;观察组患者在对照组治疗的基础上口服硫酸氢氯吡格雷片75 mg,每日1次。两组均需避免服用其他种类抗血小板药。两组均连续治疗6个月。观察两组患者的临床疗效,治疗前后血小板功能指标(CD63、CD62p),随访治疗6个月后的复发率及脑卒中发生率,记录不良反应发生情况。结果:观察组患者总有效率显著高于对照组,复发率及脑卒中发生率均显著低于对照组,差异均有统计学意义(P0.05)。治疗后,两组患者CD63、CD62p水平均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P0.05)。两组患者治疗期间均未见明显不良反应发生。结论:在常规治疗的基础上,氯吡格雷联合阿司匹林治疗老年短暂性脑缺血发作的疗效优于单用阿司匹林,可降低其复发率和脑卒中发生率,且安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of clopidogrel combined with aspirin in the treatment of senile transient ischemic attack. Methods 90 elderly patients with TIA were randomly divided into observation group (n = 50) and control group (n = 40). Both groups were given routine treatment for ischemic stroke patients, including statins, low molecular weight dextran, urokinase and other drugs. On this basis, the control group took 100 mg aspirin enteric coated tablets once a day, while the patients in the observation group took 75 mg hydroclopidogrel sulfate once a day on the basis of the treatment in the control group. Both groups should avoid taking other antiplatelet drugs. Both groups were treated continuously for 6 months. The clinical efficacy, platelet function index (CD63, CD62P), recurrence rate and stroke incidence after 6 months follow-up were observed, and adverse reactions were recorded. Results: the total effective rate in the observation group was significantly higher than that in the control group. The recurrence rate and the incidence of stroke were significantly lower in the observation group than in the control group (P0.05). After treatment, the levels of CD63P CD62P in the two groups were significantly lower than those in the same group before treatment, and the observation group was lower than the control group, the difference was statistically significant (P0.05). No significant adverse reactions occurred during treatment in both groups. Conclusion: on the basis of routine therapy, clopidogrel combined with aspirin is more effective than aspirin alone in the treatment of elderly transient ischemic attack, which can reduce the recurrence rate and the incidence of stroke, and the safety of clopidogrel combined with aspirin is better than that of aspirin alone.
【作者单位】：南阳市第三人民医院神经内科;
【分类号】：R743.31

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