华法林在椎基底动脉延长扩张症合并脑梗死/短暂性脑缺血发作的二级预防作用

Efficacy of Warfarin for Secondary Prevention of Vertebrobasilar Dolichoectasia with Cerebral Infarction or Transient Ischemic Attack

目的探讨华法林在椎基底动脉延长扩张症合并脑梗死或短暂性脑缺血发作(TIA)患者中的二级预防作用。方法将50例诊断为椎基底动脉延长扩张症合并脑梗死或TIA的患者随机分为华法林组和对照组,分别给予华法林、阿司匹林或氯吡格雷治疗,随访观察再发缺血性脑血管病及出血的发生率。结果华法林组再发缺血性脑血管病的发生率16%,低于对照组的40%,差异有统计学意义(P<0.05);华法林组出血的发生率20%,对照组为12%,但差异无统计学意义(P>0.05)。结论在椎基底动脉延长扩张症合并脑梗死/TIA的二级预防中,华法林的疗效优于抗血小板聚集治疗,而安全性无明显差异。

Objective To evaluate the efficacy of warfarin for secondary prevention of vertebrobasilar dolichoectasia with cerebral infarction or transient ischemic attack （TIA）.Methods 50 patients clinically diagnosed as vertebrobasilar dolichoectasia with cerebral infarction or transient ischemic attack were divided into two groups.The treatment group was treated with warfarin,and the control group was treated with anti-platelet agents.Incidence rate of recurrent cerebral infarction,TIA and adverse drug reaction were compared between two groups.Results In the treatment group,the incidence rate of recurrent cerebral infarction and TIA was significantly lower than the control group （P ＜ 0.05）.There was no difference in incidence rate of adverse drug reaction between the control group and the treatment group （P ＞ 0.05）.Conclusion Warfarin is more effective than antiplatelet agents for secondary prevention of vertebrobasilar dolichoectasia with cerebral infarction or transient ischemic attack（TIA）.