脑动脉支架术后不同抗血小板方案对比研究

发布时间：2018-12-13 19:28

【摘要】：目的:评价双联抗血小板药物时间及单一抗血小板药物种类对脑动脉支架术后患者的疗效和不良反应。方法:本实验为回顾性调查研究,共纳入380例病例,根据术后联合使用阿司匹林和氯吡格雷时间长短分为3组:A组(60例)联用1个月,B组(220例)联用3个月,C组(100例)联用4~12个月;根据A、B组病例停用双抗后使用单一抗血小板药物种类不同分为2个亚组:AB1组(132例)服用阿司匹林,AB2组(91例)服用氯吡格雷。通过卡方检验或Fisher精确检验及多因素logistic回归分析比较术后1年内再发脑梗死、脑出血、颅外出血、心肌梗死、死亡等不良事件发生率。结果:术后1年内,A、B、C 3组间再发脑梗死无明显差异(P=0.580);AB组亚组间脑梗死再发率也无统计学差异(P=1.000);A、B、C 3组间及AB组亚组间脑出血、颅外出血、心肌梗死、死亡发生率无统计学差别(P0.05)。结论:阿司匹林和氯吡格雷联用1个月、3个月、4~12个月以及停用双抗后单用阿司匹林或氯吡格雷具有同等疗效。
[Abstract]:Aim: to evaluate the efficacy and adverse reactions of dual antiplatelet drugs and single antiplatelet drugs in patients after cerebral artery stenting. Methods: a retrospective study was conducted in 380 patients who were divided into three groups according to the duration of combined use of aspirin and clopidogrel: group A (60 cases) and group B (220 cases) for 3 months. Group C (100 cases) were treated for 4 ~ 12 months; Patients in group A were divided into two subgroups: AB1 group (n = 132) taking aspirin and AB2 group (n = 91) taking clopidogrel. The incidence of recurrent cerebral infarction, intracerebral hemorrhage, extracranial hemorrhage, myocardial infarction and death were compared by chi-square test, Fisher accurate test and multivariate logistic regression analysis. Results: within 1 year after operation, there was no significant difference in the recurrence rate of diencephalic infarction between the two groups (P < 0. 580); AB). There was no significant difference in diencephalic hemorrhage, extracranial hemorrhage, myocardial infarction and death rate between the two groups (P0.05). Conclusion: aspirin combined with clopidogrel for 1 month, 3 months, 4 ~ 12 months, or clopidogrel alone has the same effect.
【作者单位】：重庆医科大学第一附属医院神经内科;第三军医大学新桥医院神经内科;
【基金】：重庆市医学科研计划资助项目(编号:2012-2-511)
【分类号】：R743.3

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