脑动脉支架术后不同抗血小板方案对比研究  

Comparative study of different antiplatelet therapeutic regimens after cerebral artery stenting

作　　者：卢丽[1] 卫飞[2] 唐杰[1] 李光勤[1] 

机构地区：[1]重庆医科大学第一附属医院神经内科,重庆400016 [2]第三军医大学新桥医院神经内科,重庆400037

出　　处：《重庆医科大学学报》2017年第10期1253-1257,共5页Journal of Chongqing Medical University

基　　金：重庆市医学科研计划资助项目(编号:2012-2-511)

摘　　要：目的:评价双联抗血小板药物时间及单一抗血小板药物种类对脑动脉支架术后患者的疗效和不良反应。方法:本实验为回顾性调查研究,共纳入380例病例,根据术后联合使用阿司匹林和氯吡格雷时间长短分为3组:A组(60例)联用1个月,B组(220例)联用3个月,C组(100例)联用4~12个月;根据A、B组病例停用双抗后使用单一抗血小板药物种类不同分为2个亚组:AB1组(132例)服用阿司匹林,AB2组(91例)服用氯吡格雷。通过卡方检验或Fisher精确检验及多因素logistic回归分析比较术后1年内再发脑梗死、脑出血、颅外出血、心肌梗死、死亡等不良事件发生率。结果:术后1年内,A、B、C 3组间再发脑梗死无明显差异(P=0.580);AB组亚组间脑梗死再发率也无统计学差异(P=1.000);A、B、C 3组间及AB组亚组间脑出血、颅外出血、心肌梗死、死亡发生率无统计学差别(P>0.05)。结论:阿司匹林和氯吡格雷联用1个月、3个月、4~12个月以及停用双抗后单用阿司匹林或氯吡格雷具有同等疗效。Objective：To compare the efficacy and adverse events of dual antiplatelet drugs in different durations and single an- tiplatelet drug for patients after cerebral artery stenting. Methods：The experiment is a investigative and retrospective study,and 380 patients were admitted. According to the durations of dual antiplatelet（aspirin and clopidogrel） after cerebral artery stenting,the pa-tients were divided into three groups：group A（60 cases） for 1 month, the group B（220 cases） for 3 months, group C （100 cases） for 4 to 12 months. According to the different single antiplatelet drugs after dual antiplatelet regimen,the patients of group A and group B were divided into two subgroups：AB1 group （132 cases） for aspirin,AB2（91 cases） for clopidogrel. By chi-squaretest or Fisher＇s exact test and muhifactor Logistic regression analysis, the recurrence incidence of cerebral infarction, cerebral hemor- rhage, extracranial blood, myocardial infarction, death within 1 year after cerebral artery stenting were compared. Results：There was no significant difference in the incidence of cerebral infarction recurrence （P=0.580） among group A,B,C;and no statistical dif- ference （P=1.000） between group ABi and AB2. There was no statistical differences in myocardial infarction,cerebral hemorrhage and extracranial blood, death among group A, B, C and between group AB 1, AB2. Conclusion ： Taking aspirin and clopidogrel together for 1 month,3 months,and 4 to 12 months has the same effect,the same as taking aspirin or clopidogrel alone after dual antiplatelet.

关 键 词：支架术 抗血小板药物 对比研究 

分 类 号：R743.1[医药卫生—神经病学与精神病学]