阿司匹林联合氯吡格雷对缺血性轻度颈动脉狭窄患者脑卒中二级预防的作用分析(1)
摘要：目的 研究和探討阿司匹林联合氯吡格雷对缺血性轻度颈动脉狭窄患者脑卒中二级预防的作用。方法 选取2015年11月～2016年10月在本院确诊为缺血性轻度颈动脉狭窄患者，所有确诊的患者均经过全脑血管造影术(DSA)检查其狭窄率小于50%，所有患者均服用他汀类药物，将阿司匹林联合氯吡格雷进行治疗的患者设定为双联抗血小板药物组(双抗组)，将单独使用阿司匹林或者氯吡格雷进行治疗的患者设定为单联抗血小板药物组(单抗组)。比较分析两组在入院时经过改良之后的Rankin评分(mRS评分)结果、美国国立卫生研究院关于卒中神经功能残损情况的评分(NIHSS)结果以及电话随机访问调查出院后1年的患者所呈现的mRS评分结果、卒中复发情况和不良血管时间等方面的差异性。结果 此次研究共搜集了151例缺血性轻度颈动脉狭窄患者，其中双抗组有99例，单抗组有52例，排除10例已经失访调查的患者，双抗组的患者改为93例，单抗组的患者改为48例。根据研究结果显示，双抗组与单抗组的同侧卒中复发率分别为2.20%和8.40%；非同侧卒中复发率分别为1.20%和2.20%；病死率分别为2.10%和4.10%，且两组之间的差异性存在无统计学意义(P>0.05)；出血发生率分别为11.70%和0，且两组之间的差异性存在统计学意义(P<0.05)。结论 针对颈动脉狭窄率小于50%的患者，单独采用阿司匹林或者氯吡格雷进行预防治疗，其治疗过程会更加安全。
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关键词： 阿司匹林；氯吡格雷；脑卒中
中图分类号：R743.3 文献标识码：A 文章编号：1006-1959(2017)16-0074-02
Effect of Aspirin Combined with Clopidogrel on Secondary Prevention of Stroke in Patients with Ischemic Mild Carotid Artery Stenosis
BAO Yue-ning1，ZHANG Peng-ju2
(1.Department of Neurology，Guyuan People's Hospital，Guyuan 756000，Ningxia，China；
2.Department of Anesthesiology，Maternal and Child Health Hospital of Ningxia Hui Autonomous Region，Yinchuan 750004，Ningxia，China)
, 百拇医药
Abstract：Objective To investigate the effect of aspirin combined with clopidogrel on secondary prevention of stroke in patients with ischemic mild carotid artery stenosis.Methods From November 2015 to October 2016 in our hospital diagnosed with mild stenosis of carotid artery in patients with ischemic，all patients were diagnosed by cerebral angiography(DSA)examination of the stenosis rate of less than 50%，all patients were taking statins，the combination of aspirin and clopidogrel treatment were set to dual antiplatelet drugs group(double antibody group)，the use of aspirin or clopidogrel alone for the treatment of patients with set single antiplatelet therapy group(mAb group).The results of the National Institutes of Health's assessment of stroke neurological impairment(NIHSS)and the randomized visit to patients who were hospitalized 1 year after discharge were compared with the results of the Rankin score(mRS score) stroke recurrence and poor vascular time.Results This study collected 151 cases of carotid artery mild stenosis of ischemic，the double resistance group had 99 cases，mAb group had 55 cases，10 cases had lost investigation excluded，double resistance group of patients to 93 cases，monoclonal antibody group of patients to 48 cases.According to the results of the study，the recurrence rate of ipsilateral stroke was 2.20% and 8.40% in the double antibody group and the monoclonal antibody group，respectively.The recurrence rate of the ipsilateral stroke was 1.20% and 2.20% respectively，and the fatality rate was 2.10% and 4.10% respectively，and the difference between the two groups has no statistical significance(P>0.05)；bleeding rates were 11.70% and 0，and the difference between the two groups has statistical significance(P<0.05).Conclusion For patients with carotid stenosis rate of less than 50%，the treatment of aspirin or clopidogrel alone will be more safe., 百拇医药(鲍月宁 张鹏举)
, http://www.100md.com
关键词： 阿司匹林；氯吡格雷；脑卒中
中图分类号：R743.3 文献标识码：A 文章编号：1006-1959(2017)16-0074-02
Effect of Aspirin Combined with Clopidogrel on Secondary Prevention of Stroke in Patients with Ischemic Mild Carotid Artery Stenosis
BAO Yue-ning1，ZHANG Peng-ju2
(1.Department of Neurology，Guyuan People's Hospital，Guyuan 756000，Ningxia，China；
2.Department of Anesthesiology，Maternal and Child Health Hospital of Ningxia Hui Autonomous Region，Yinchuan 750004，Ningxia，China)
, 百拇医药
Abstract：Objective To investigate the effect of aspirin combined with clopidogrel on secondary prevention of stroke in patients with ischemic mild carotid artery stenosis.Methods From November 2015 to October 2016 in our hospital diagnosed with mild stenosis of carotid artery in patients with ischemic，all patients were diagnosed by cerebral angiography(DSA)examination of the stenosis rate of less than 50%，all patients were taking statins，the combination of aspirin and clopidogrel treatment were set to dual antiplatelet drugs group(double antibody group)，the use of aspirin or clopidogrel alone for the treatment of patients with set single antiplatelet therapy group(mAb group).The results of the National Institutes of Health's assessment of stroke neurological impairment(NIHSS)and the randomized visit to patients who were hospitalized 1 year after discharge were compared with the results of the Rankin score(mRS score) stroke recurrence and poor vascular time.Results This study collected 151 cases of carotid artery mild stenosis of ischemic，the double resistance group had 99 cases，mAb group had 55 cases，10 cases had lost investigation excluded，double resistance group of patients to 93 cases，monoclonal antibody group of patients to 48 cases.According to the results of the study，the recurrence rate of ipsilateral stroke was 2.20% and 8.40% in the double antibody group and the monoclonal antibody group，respectively.The recurrence rate of the ipsilateral stroke was 1.20% and 2.20% respectively，and the fatality rate was 2.10% and 4.10% respectively，and the difference between the two groups has no statistical significance(P>0.05)；bleeding rates were 11.70% and 0，and the difference between the two groups has statistical significance(P<0.05).Conclusion For patients with carotid stenosis rate of less than 50%，the treatment of aspirin or clopidogrel alone will be more safe., 百拇医药(鲍月宁 张鹏举)
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