阿司匹林联合氯吡格雷治疗症状性轻度颈动脉狭窄的效果观察

Interventional effect of aspirin combined with clopidogrel on symptomatic mild carotid artery stenosis

目的观察阿司匹林联合氯吡格雷治疗症状性轻度颈动脉狭窄的效果。方法选2013-04-2014-11就诊的症状性颈动脉狭窄患者126例,随机分为联合组63例和对照组63例。两组患者均给予氯吡格雷75 mg/d口服治疗,联合组同时给予阿司匹林100 mg/d治疗,均治疗3个月,比较两组患者治疗效果及不良反应发生率,彩超检测对比用药前后患者颈动脉内膜中层厚度（IMT）变化情况。结果联合组显效28例,有效24例,无效11例;对照组显效18例,有效23例,无效22例。联合组疗效优于对照组（P〈0.05）。两组患者用药后彩超检测IMT值均显著下降（P〈0.05）;联合组用药后IMT值为（0.75±0.12）mm,与对照组[（0.79±0.15）mm]比较,差异无统计学意义（P〉0.05）。联合组不良反应发生率为47.6%,与对照组（33.3%）比较差异无统计学意义（P〉0.05）。结论阿司匹林联合氯吡格雷治疗症状性轻度颈动脉狭窄患者临床效果好,安全性高,值得推广。

Objective To study the interventional effect of aspirin combined with clopidogrel on symptomatic mild carotid artery stenosis. Methods One hundred and twenty-six patients with symptomatic carotid artery stenosis in our hospital from April 2013 to November 2014 were taken as the research subjects and randomly divided into the combination group（ n = 63） and the control group（ n = 63）. All the patients were treated with oral clopidogrel,75 mg / d. The combined group was treated with aspirin（ 100 mg / d） at the same time. The two groups were treated for 3months. The curative effects and incidence of adverse reactions were compared between the two groups. The carotid intima media thickness（ IMT） was compared before and after the treatment in both of the two groups. Results 28 cases were markedly effective,24 cases effective and 11 cases ineffective in the combination group while,18 cases were markedly effective,23 cases effective and 22 cases ineffective in the control group. There was a significant difference in curative effect between the two groups（ P〈 0. 05）; After the medication,the IMT values of both the two groups decreased significantly（ P〈 0. 05）; There was no significant differenc in IMT between the combination group（ 0. 75 ±0. 12） mm and the control group（ 0. 79 ± 0. 15） mm（ P〉 0. 05）. There was no significant difference in the incidence of adverse reactions between the combination group（ 47. 6%） and the control group（ 33. 3%）（ P〉 0. 05）. Conclusion Aspirin combined with clopidogrel is safe and effective in the treatment of symptomatic mild carotid artery stenosis.