国产氢氯吡格雷在脑血管支架成形术围手术期应用的疗效和安全性观察  

Safety and Effectiveness on Domestic Hydrogen Clopidogrel in Perioperative Patients with Carotid Angioplasty and Stenting

作　　者：余小艳[1] 端光鑫 刘文鹏[1] 徐加平[1] 石际俊[1] 章春园[1] 肖国栋[1] 曹勇军[1] 

机构地区：[1]苏州大学附属第二医院神经内科,江苏苏州215004

出　　处：《中国血液流变学杂志》2015年第1期22-25,共4页Chinese Journal of Hemorheology

基　　金：国家自然科学基金面上项目（81471195）;苏州市科技发展计划项目（SYSD2012083）

摘　　要：目的：观察国产氢氯吡格雷（泰嘉）在脑血管支架成形术（CAS）围手术期应用的疗效和安全性。方法入选拟行脑血管支架成形术的患者共20例，所有患者至少于术前7 d予以国产氢氯吡格雷，75 mg/天，术后继续口服3个月，期间均合用拜阿斯匹灵肠溶片（阿司匹林）200 mg/晚。观察3个月随访期内有无心脑血管事件及药物不良反应发生。结果20例患者中，共置入支架24枚，手术成功率100%。用药后3个月与入组时相比较，FBG、LDL-C、CRP、Fg均有所下降，差异具有统计学意义（P＜0.05）；白细胞计数、血肌酐有所升高，血小板计数稍降低，血ALT、AST稍有升高，差异无统计学意义。用药后3个月平均NIHSS评分与入组时相比显著下降，差异具有统计学意义（8.64±2.22 vs 4.54±2.78，P=0.004）；3个月随访时mRS评分（1.60±0.78），大部分患者神经功能恢复良好（mRS≤2分，16/20，80%）。围手术期发生短暂性脑缺血发作（TIA）1例。术后随访期间发生肝功能轻度受损2例，皮肤瘙痒1例，无其他心脑血管事件及药物不良反应发生。结论国产氢氯吡格雷用于CAS围手术期疗效可靠，安全性良好，可以作为CAS围手术期与阿司匹林联合抗血小板治疗的药物。Objective To observe safety and effectiveness of domestic hydrogen clopidogrel （Tai-jia） in perioperative patients with carotid angioplasty and stenting （CAS）.Methods20 patients who would undergo CAS were enrolled in this study. All patients were given Tai-jia at a dose of 75 mg per day for at least 7 days prior to the operation, followed by 75 mg per day for 3 months. All the participants received aspirin at a dose of 75 mg during the study period. Cardio-cerebrovascular events and side effects were observed during the 3-month follow-up period.Results Of 20 patients enrolled, 24 stents were placed. The successful rate of operation was 100%. There were statistically signifi cant differences in FBG, LDL-C, CRP and Fg between the origin and end of the follow-up period （P〈0.05）. However, no signifi cant differences in white blood cell counts, serum creatinine, platelet counts, ALT and AST; In addition, there were statistically significant differences in NIHSS score （8.64±2.22 vs 4.54±2.78,P=0.004）, and most patients recovered well at the end of the follow-up period （mRS 1.60±0.78, mRS≤2, 80%）. 1 case was defi ned as TIA during the perioperative period. 2 cases of mild liver dysfunction and 1 case of itch were found during the study period. There were no cardio-cerebrovascular events and adverse drug reactions.Conclusion The safety and effectiveness of domestic hydrogen clopidogrel （Tai-jia） are satisfactory in perioperative patients with CAS, and the combination antiplatelet therapy of Tai-jia with aspirin can be used in perioperative period of CAS.

关 键 词：国产氢氯吡格雷 脑血管支架成形术 疗效 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]