是否伴发脑微出血对缺血性脑血管病患者应用抗血小板药后期脑血管事件发生率影响的临床分析Δ  

Effects of Cerebral Microbleeds on the Incidence of Cerebral Events in Patients with Ischemic Cerebrovascular Disease at the Last Stage of Antiplatelet Agent

作　　者：刘春洁[1] 郑海亮[2] 李晓晴[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,北京100029 [2]首都医科大学附属北京世纪坛医院医学工程处,北京100038

出　　处：《中国药房》2016年第17期2361-2363,共3页China Pharmacy

基　　金：北京市自然科学基金资助项目(No.1152003)

摘　　要：目的:比较是否合并脑微出血(CMBs)的缺血性脑血管病患者应用抗血小板药物后期脑血管事件的发生率。方法:选择首都医科大学附属北京安贞医院2013年1月-2014年1月缺血性脑血管病患者140例,根据其是否合并CMBs分为CMBs组和非CMBs组,各70例。两组患者随访(随访期间规律服用阿司匹林100 mg/d和/或氯吡格雷75 mg/d)1年后,比较其再发脑梗死及脑出血的发生率及病死率。结果:CMBs组再发脑梗死的发生率为12.9%,非CMBs组为8.6%,组间比较差异无统计学意义(P=0.412);CMBs组脑出血的发生率为10.0%,非CMBs组为1.4%,组间比较差异有统计学意义(P=0.029);CMBs组后期脑血管事件的病死率为5.7%,非CMBs组为4.3%,组间比较差异无统计学意义(P=0.698)。结论:合并CMBs的缺血性脑血管病患者应用抗血小板药物后,脑出血的风险增加。对于伴CMBs的缺血性脑血管病患者,在选择抗血小板药物时应充分权衡获益及出血风险。OBJECTIVE：To compare the incidence of cerebral events in patients with ischemic cerebrovascular disease complicating with cerebral microbleeds（CMBs）at the last stage of antiplatelet agent use. METHODS：140 patients with ischemic cerebrovascular disease were selected from Beijing Anzhen Hospital Affilicated to Capital Medical University during Jan. 2013-Jan. 2014,and then divided into CMBs group and non-CMBs group according to whether complicated with CMBs,with 70 cases in each group. After followed up for 1 year（regular use of aspirin 100 mg/d and/or clopidogrel 75 mg/d）,the incidence of recurrent cerebral infarction and cerebral bleeding and mortality were compared. RESUTLS：The incidence of recurrent cerebral infarction was12.9% in CMBs group and 8.6% in non-CMBs group,without statistical significance（P=0.412）;the incidence of cerebral bleeding was 10.0% in CMBs group and 1.4% in non-CMBs group,with statistical significance（P=0.029）;the mortality of cerebrovascular event at the last stage was 5.7% in CMBs group and 4.3% in non-CMBs group,without statistical significance（P=0.698）. CONCLUSIONS：The risk of cerebral bleeding increase in patients with ischemic cerebrovascular disease complicating with CMBs after the application of antiplatelet agent. For patients with ischemic cerebrovascular disease complicating with CMBs,the application of antiplatelet agent should be based on the complete judgment and weighing of benefit and bleeding risk.

关 键 词：抗血小板药物 缺血性脑血管病 脑微出血 脑血管事件 

分 类 号：R743[医药卫生—神经病学与精神病学]