替格瑞洛片治疗脑动脉狭窄伴小血管病患者的临床研究  

Clinical trial of ticagrelor tablets in the treatment of cerebral artery stenosis patients with small vessel disease

作　　者：李欣[1] 侯金宇 田月明[1] 刘静[1] 阚凤杰[1] 曹亦宾[1] LI Xin;HOU Jin-yu;TIAN Yu E-ming;LIU Jing;KAN Feng-jie;CAO Yi-bin(Department of Neurology Two,Tangshan 063000,Hebei Province,China;Physical Examination Center,Tangshan Gongren Hospital, Tangshan 063000,Hebei Province,China)

机构地区：[1]唐山市工人医院神经内二科,河北唐山063000 [2]唐山市工人医院体检中心,河北唐山063000

出　　处：《中国临床药理学杂志》2018年第23期2690-2692,2696,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省卫生厅重点科技研究计划基金资助项目(20181256)

摘　　要：目的观察替格瑞洛联合普罗布考+阿司匹林+他汀类药物(PAS)治疗脑动脉狭窄伴小血管病患者的临床疗效和安全性。方法将140例脑动脉狭窄伴小血管病患者随机分为对照组和试验组,每组70例。对照组口服阿司匹林100 mg·d^(-1),每天1次,每晚睡前口服阿托伐他汀10 mg·d^(-1),口服普罗布考,每次0. 5 g,于每天早、晚餐服用,均连续服用3个月。试验组在对照组的基础上加服替格瑞洛治疗,首剂服用180 mg,之后服用90 mg·d^(-1),每天1次,连续服用3个月。比较2组患者的临床疗效,检测2组的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血管内皮素-1(ET-1)和一氧化氮(NO)水平,观察2组的药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为98. 57%(69例/70例)和80. 00%(56例/70例),差异有统计学意义(P <0. 05)。治疗后,试验组和对照组的TC分别为(4. 19±0. 28)和(5. 24±0. 34) mmol·L^(-1),TG分别为(1. 72±0. 25)和(1. 96±0. 29) mmol·L^(-1),HDL-C分别为(1. 87±0. 36)和(1. 50±0. 23) mmol·L^(-1),LDL-C分别为(2. 45±0. 34)和(3. 06±0. 38)mmol·L^(-1),ET-1分别为(60. 46±12. 82)和(69. 33±14. 03)μg·L^(-1),NO分别为(381. 71±68. 21)和(335. 95±58. 02)μmol·L^(-1),差异均有统计学意义(均P <0. 05)。2组的药物不良反应主要为消化道出血,颅内出血,胃肠道反应和皮疹,对照组和试验组的药物不良反应发生率分别为11. 43%(8例/70例)和14. 29%(10例/70例),差异无统计学意义(P> 0. 05)。结论替格瑞洛联合PAS方案治疗脑动脉狭窄伴小血管病的临床疗效优于单用PAS方案,其能够有效调节内皮功能,且未增加药物不良反应发生率。Objective To observe the clinical efficacy and safety of ticagrelor combined with probucol,aspirin plus and statins (PAS) in the treatment of cerebral artery stenosis patients with small vascular disease. Methods A total of 140 patients with cerebral artery stenosis and small vessel disease were randomly divided into control group and treatment group,with 70 patients in each group.Control group was orally given aspirin 100 mg·d^-1,qd,orally given atorvastatin 10 mg·d^-1 before bedtime every night,orally given probucol 0.5 g·time-1,taken at breakfast and dinner every day for 3 months.Treatment group was given ticagrelor on the basis of control group,given 180 mg for the first time,then given 90 mg·d^-1,qd,for 3 months.The clinical efficacy in two groups were observed.The total cholesterol (TC) , triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) ,low density lipoprotein cholesterol (LDL-C) ,endothelin-1 (ET-1) ,nitric oxide (NO) ,adverse drug reactions between two groups were observed.Results After treatment,the total effective rates in treatment group and control group were 98.57% (69 cases /70 cases) and 80.00% (56 cases /70 cases) ,with significant difference (P<0.05) .After treatment,in treatment group and control group,TC were (4.19±0.28) and (5.24±0.34) mmol·L^-1,TG were (1.72 ±0.25) and (1.96 ±0.29) mmol·L^-1,HDL-C were (1.87 ±0.36) and (1.50 ±0.23) mmol·L^-1,LDL-C were (2.45±0.34) and (3.06±0.38) mmol·L^-1,ET-1 were (60.46±12.82) and (69.33±14.03) mg·L^-1,NO were (381.71±68.21) and (335.95±58.02) μmol·L^-1,all with significant differences (all P<0.05) .The adverse drug reactions in two groups were mainly gastrointestinal bleeding,intracranial hemorrhage,gastrointestinal reaction and rash,the incidence of adverse drug reactions in control group and treatment group were 11.43% (8 cases /70 cases) and 14.29% (10 cases /70 cases) ,with no statistical difference (P > 0.05) . Conclusion The clinical efficacy of ticagrelor combined PAS regimen in the treatment of cerebral arte

关 键 词：替格瑞洛片 脑动脉狭窄 内皮功能 临床疗效 

分 类 号：R972[医药卫生—药品]