上消化道出血高危的急性脑梗死患者应用西洛他唑治疗有效性和安全性的研究

Cilostazol for patients with acute cerebral infarction combined with upper digestive tract hemorrhage

目的 观察合并上消化道出血（UGH）高危因素的急性脑梗死患者应用西洛他唑片治疗的有效性和安全性.方法 将120例合并UGH高危因素的急性脑梗死患者随机分为两组,阿司匹林组（A组,n=60）：口服拜阿司匹林片100 mg,1次/天.西洛他唑组（B组,n=60）：口服西洛他唑片100 mg,2次/天.观察随访疗程为6个月,监测治疗前后的血脂指标,记录治疗过程中消化道事件,评估临床疗效.结果 A组与B组临床治疗总有效率比较,差异无统计学意义（88.33％vs.86.67％）,P＞0.05;治疗后,B组HDL-C水平显著升高（1.02±0.19vs.1.20±0.18）,P＜0.05;B组消化道事件显著低于A组（1例vs.9例）,P＜0.01.结论 合并UGH高危因素的急性脑梗死患者应用西洛他唑抗血小板治疗是有效和安全的.

Objective To observe the effect and safety of cilostazol for patients with cerebral infarction combined with upper digestive tract hemorrhage risk factors.Methods 120 patients with acute cerebral infarction and UGH risk factors were randomly divided into an aspirin group （group A,n=60,orally taking aspirin once a day,100 mg once） and a cilostazol group （group B,n=60,orally taking cilostazol twice a day,100 mg once）.All patients were observed and followed up for 6 months.The lipid indexes were monitored before and after the treatment,gastrointestinal events during the treatment recorded,and clinical curative effect evaluated.Results There were no statistical difference in clinical efficacy between the two groups （88.33% vs.86.67%,P 〉 0.05）.After the treatment,the HDL-C level increased more significantly in group B than in group A [（1.02 ± 0.19） vs.（1.20 ± 0.18）,P 〈 0.05].Fewer patients occurred gastrointestinal events in group B than in group A （1 case vs.9 cases,P 〈 0.05）.Conclusions Cilostazol for patients with acute cerebral infarction associated and UGH risk factors is effective and safe.