国产氯吡格雷联合桂哌齐特、丹红注射液治疗椎基底动脉供血不足所致眩晕的回顾性研究

A retrospective clinical study of clopidogrel combined with cinepazide and Danhong injection in the treatment of vertigo caused by VBI

目的：评价国产氯吡格雷联合桂哌齐特、舒血宁注射液治疗椎基底动脉供血不足（ VBI ）所致眩晕的有效性与安全性。方法选取104例VBI患者，随机分为治疗组54例与对照组50例。对照组予马来酸桂哌齐特及丹红注射液静脉滴注，治疗组在对照组基础上加用氯吡格雷。连续治疗7～21d后评估患者的眩晕程度，采用TCD检测椎基底动脉血流速度，同时随访30d记录短暂性脑缺血（ TIA）及脑梗死发生人数。结果治疗组0～2h起效（48．1％vs．28．0％）的患者及0～6h起效（85．2％vs．58．0％）的患者占比率显著高于对照组，2组比较差异有统计学意义（P＜0．05）；治疗组显效率（64．8％vs．42．0％）、总有效率（92．6％vs．76．0％）均明显高于对照组，2组比较差异有统计学意义（P ＜0．05）。 TCD 检测治疗组与对照组治疗后 TCD 血流速度（cm／s）比较，左侧椎动脉比较为（44．2±10．7） vs．（42．8±11．6）、右侧椎动脉比较为（42．8±10．7） vs．（37．6±10．8）、基底动脉比较为（43．2±10．3） vs．（41．7±10．4），治疗组的血流速度改善更为明显。2组比较差异有统计学意义（P＜0．05）；治疗组30d内无发生TIA或脑卒中病例，对照组发生TIA 3例，1例进展为脑卒中，发生率为8％。2组比较差异有统计学意义（ P＜0．05）；2组治疗过程中均未发生严重的不良反应。结论氯吡格雷联合桂哌齐特、丹红注射液可显著改善椎—基底动脉供血不足所致眩晕，治疗过程极少发生不良反应，值得临床推广应用。

Objective To evaluate the efficacy and safety of clopidogrel combined with cinepazide and Danhong in -jection in the treatment of vertigo caused by insufficient vertebrobasilar （ Vertebral-basilar artery insufficiency VBI ） .Methods 104 cases of VBI patients were randomly divided into treatment group （54 cases） and control group （50 cases）.The controlgroup was treated with maleic acid cinepazide injection and Danhong injection ,the treatment group was added with clopidogrelbased on the control group.After continuous treatment for 7 ～21d,assess the vertigo degree of patients.The TCD was used todetect the blood flow velocity of vertebral basilar artery .At the same time,followed up for 30d,then recorded the numbers ofTIA and cerebral infarction.Results The 0 ～2h onset （48.1% vs.28.0%） and 0 ～6h onset （85.2% vs.58.0%） of thepatients in treatment group was significantly higher than the control group ,the differences were statistically significant （P 〈0.05）.The significant efficiency （ 64.8% vs.42.0%） and total efficiency （92.6% vs.76.0%） in treatment group weresignificantly higher than the control group,the differences were statistically significant （P 〈0.05）.The TCD detection of treatmentgroup and control group showed that the blood flow velocity （cm/s） of left vertebral artery was （44.2 ±10.7 vs.42.8 ±11.6）,right vertebral artery was （42.8 ±10.7 vs.37.6 ±10.8）,basilar artery was （43.2 ±10.3 vs.41.7 ±10.4）,and thedifferences were statistically significant （P 〈0.05）.There were no TIA or stroke cases in the treatment group in 30 days,butin the control group,3 patients had TIA,and 1 patients developed into cerebral stroke,the incidence was 8%,the differenceswere statistically significant（P 〈0.05）.There were no serious adverse reactions in the course of treatment in the 2 groups. Conclusion Clopidogrel combined with cinepazide and Danhong injection can significantly improve the vertigo caused byVBI,with few adverse reactions during treatment ,which is worthy of clinical application.