替格瑞洛联合阿司匹林治疗急性脑梗死的效果及安全性  

Effect and safety of ticagrelor combined with aspirin in treating cerebral infarction at acute stage

作　　者：林彬[1] 生娣[1] 

机构地区：[1]新疆医科大学附属中医医院重症医学科,乌鲁木齐830000

出　　处：《中国医药》2016年第4期524-527,共4页China Medicine

摘　　要：目的 观察替格瑞洛联合阿司匹林治疗急性脑梗死的效果及其安全性.方法 选取2014年1月至2015年2月于新疆医科大学附属中医医院住院治疗的81例急性脑梗死患者,按入院时间随机分为对照组（40例）和联合组（41例）,2组均进行控制血压、血糖、血脂及常规他汀类药物、营养神经等治疗,对照组给予阿司匹林肠溶片100 mg,口服,1次/d,联合组在对照组基础上联合使用替格瑞洛,首次负荷剂量180 mg/d,之后服用90 mg/次,2次/d,2组疗程均为14 d.治疗前后测定患者血浆高敏C反应蛋白（hs-CRP）和血小板聚集率,采用美国国立卫生研究院卒中量表进行临床神经功能缺损程度评分,并评定患者临床疗效.观察不良反应发生情况.结果 治疗前2组患者的hs-CRP水平、血小板聚集率差异无统计学意义（P＞0.05）,治疗7d后对照组与联合组患者hs-CRP水平均高于治疗前[（12±3）mg/L比（7±3） mg/L、（10±3）mg/L比（6±3）mg/L],血小板聚集率均低于治疗前[（31±11）％比（57±12）％、（14±12）％比（57±11）％],且联合组的hs-CRP水平、血小板聚集率均明显低于对照组,差异均有统计学意义（均P＜0.05）.联合组治疗后总有效率明显高于对照组[95.1％（39/41）比87.5％ （35/40）],差异有统计学意义（P＜0.05）.2组患者均无严重不良反应发生.结论 联合服用替格瑞洛治疗急性脑梗死较单用阿司匹林疗效更确切,且不良反应少,安全性高.Objective To observe the effect and safety of ticagrelor combined with aspirin in treating cerebral infarction at acute stage.Methods Totally 81 patients with cerebral infarction at acute stage from January 2014 and February 2015 were randomly divided into control group （40 cases） and combination group （41 cases）.Both group were given therapy of controlling blood pressure,blood glucose and blood lipid and neurotrophy treatment;in addition,aspirin enteric tablets （100 mg/d,1 time/d） was orally administrated in control group,aspirin enteric tablets plus ticagrelor （90 mg/time,2 times/d,180 mg at the first time） were orally administrated in combination group for 14 d.The high-sensitivity C-reactive protein （hs-CRP）,platelet aggregation rate,national institute of health stroke scale （NIHSS） scores before and after treatment were measured,the effect and adverse reaction were observed.Results The hs-CRP,platelet aggregation rate were not significantly different between groups before treatment （P 〉0.05）.After 7 d of treatment,the hs-CRP was significantly increase,the platelet aggregation rate was significantly reduced compared with those before treatment in control group [（12 ± 3） mg/L vs （7 ±3） mg/L,（31 ± 11）% vs （57 ± 12）%] and combination group [（10 ±3） mg/L vs （6 ±3） mg/L,（14 ± 12）% vs （57 ± 11）%],moreover,the hs-CRP and platelet aggregation rate in combination group were significantly lower than those in control group after treatment （P 〈 0.05）.The effective rate in combination group was significantly higher than that in control group [95.1% （39/41） vs 87.5% （35/40）] （P 〈 0.05）.No adverse events occurred in both groups.Conclusion Combination of ticagrelor and aspirin is better than single aspirin in treatment of cerebral infarction at acute stage,with high safety.

关 键 词：脑梗死 急性期 替格瑞洛 阿司匹林 

分 类 号：R743[医药卫生—神经病学与精神病学]