血塞通注射液联合瑞舒伐他汀对颅外脑血管支架植入术后再狭窄的影响

Effect of Xuesaitong Injection Combined with Rosuvastatin on Restenosis after Extracranial Cerebral Vascular Stent Implantation

目的 :探讨血塞通注射液联合瑞舒伐他汀对颅外脑血管支架植入术后再狭窄的影响。方法 :选取我院2013年4月—2016年4月收治的240例行颅外脑血管支架植入术患者,按随机数字表法分为观察组和对照组,各120例。对照组常规予以抗血小板治疗[术前口服氯吡格雷(75 mg,qd)+阿司匹林(100 mg,qd),术中和术后皮下给予低分子肝素(术中全身肝素化0.75 mg/kg,术后给予低分子肝素钠4250 IU,im,q12h)]、降脂[瑞舒伐他汀(10 mg,qd)]治疗,观察组在对照组的基础上加用血塞通注射液(450 mg加入250m L0.9%氯化钠注射液静脉滴注,qd),疗程均为6个月;术后随访一年,每3月行颅外脑血管超声检查,比较两组并发症发生情况、治疗前后血清炎症因子和凝血功能指标水平、脑血管再狭窄发生情况及不良反应情况。结果 :两组术后并发症发生率比较,差异无统计学意义(P> 0.05);治疗后两组超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-1β、全血黏度、纤维蛋白原(Fib)水平均降低,且观察组低于对照组,差异有统计学意义(P <0.05);治疗后两组血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平高于治疗前,且观察组高于对照组,差异有统计学意义(P <0.05);随访1年内,观察组脑血管再狭窄发生率为6.7%,低于对照组的15.8%,差异有统计学意义(P <0.05);两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 :血塞通注射液联合瑞舒伐他汀可有效降低脑梗死颅外脑血管支架植入术后再狭窄的发生率,且安全性较高,适合临床推广应用。

Objective:To investigate the effect of xuesaitong injection combined with rosuvastatin on restenosis after extracranial cerebral stent implantation.Methods:240 patients who underwent extracranial cerebral stent implantation admitted to our hospital from April 2013 to April 2016 were selected and divided into an observation group and a control group according to the random number table method,120 cases in each group.The patients in the control group were given conventional antiplatelet treatment[preoperative oral clopidogrel(75 mg,qd)+aspirin(100 mg,qd),subcutaneous administration of low-molecular-weight heparin during and after operation(intraoperative systemic heparinization 0.75 mg/kg,postoperative administration of low molecular weight heparin sodium 4250 IU,im,q12h)]and lipid-lowering treatment[rosuvastatin(10 mg,qd)],and the patients in the observation group were treated with xuesaitong injection on the basis of the control group(intravenous drip of 250 mL 0.9%sodium chloride injection added with 450 mg xuesaitong),6 months as a course of treatment.All patients were followed up for one year after operation and examined by extracranial cerebrovascular ultrasonography every 3 months.The incidence of complications,the levels of serum inflammatory factors and coagulation function indexes before and after treatment and the occurrence of cerebrovascular restenosis and adverse reactions were compared between the two groups.Results:There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).After treatment,the levels of high-sensitivity C-reactive protein(hs-CRP),interleukin(IL)-6,IL-1β,whole blood viscosity and fibrinogen(Fib)were decreased,and the levels in the observation group were lower than those in the control group,with statistically significant difference(P<0.05).The levels of plasma prothrombin time(PT)and activated partial thromboplastin time(APTT)after treatment were higher than those before treatment,and the levels in the observation group were higher than those in the control group,with statistically significant difference(P<0.05).During the follow-up period of one year,the incidence of cerebrovascular restenosis in the observation group was 6.7%,which was lower than 15.8%in the control group,with statistically significant difference(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Xuesaitong injection combined with rosuvastatin can effectively reduce the incidence of restenosis after extracranial cerebral vascular stent implantation in the patients with cerebral infarction,which is safe and suitable for clinical application.