【摘要】：目的:評(píng)價(jià)雙聯(lián)抗血小板藥物時(shí)間及單一抗血小板藥物種類(lèi)對(duì)腦動(dòng)脈支架術(shù)后患者的療效和不良反應(yīng)。方法:本實(shí)驗(yàn)為回顧性調(diào)查研究,共納入380例病例,根據(jù)術(shù)后聯(lián)合使用阿司匹林和氯吡格雷時(shí)間長(zhǎng)短分為3組:A組(60例)聯(lián)用1個(gè)月,B組(220例)聯(lián)用3個(gè)月,C組(100例)聯(lián)用4~12個(gè)月;根據(jù)A、B組病例停用雙抗后使用單一抗血小板藥物種類(lèi)不同分為2個(gè)亞組:AB1組(132例)服用阿司匹林,AB2組(91例)服用氯吡格雷。通過(guò)卡方檢驗(yàn)或Fisher精確檢驗(yàn)及多因素logistic回歸分析比較術(shù)后1年內(nèi)再發(fā)腦梗死、腦出血、顱外出血、心肌梗死、死亡等不良事件發(fā)生率。結(jié)果:術(shù)后1年內(nèi),A、B、C 3組間再發(fā)腦梗死無(wú)明顯差異(P=0.580);AB組亞組間腦梗死再發(fā)率也無(wú)統(tǒng)計(jì)學(xué)差異(P=1.000);A、B、C 3組間及AB組亞組間腦出血、顱外出血、心肌梗死、死亡發(fā)生率無(wú)統(tǒng)計(jì)學(xué)差別(P0.05)。結(jié)論:阿司匹林和氯吡格雷聯(lián)用1個(gè)月、3個(gè)月、4~12個(gè)月以及停用雙抗后單用阿司匹林或氯吡格雷具有同等療效。
[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.
【作者單位】： 重慶醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科;第三軍醫(yī)大學(xué)新橋醫(yī)院神經(jīng)內(nèi)科;
【基金】：重慶市醫(yī)學(xué)科研計(jì)劃資助項(xiàng)目(編號(hào):2012-2-511)
【分類(lèi)號(hào)】：R743.3

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