双抗血小板治疗中高危短暂性脑缺血发作非心房纤颤患者的疗效探讨

To Observe the Effective of Dual Antiplatelet Therapy in Midst and Highrisk TIA Patients with Non-atrial Fibrilation

目的探讨双抗血小板治疗在短暂性脑缺血发作(transient ischemic attack,TIA)中的疗效及安全性。方法方便选取该院2011年3月—2015年5月期间收治的56例中高危TIA非心房纤颤患者,随机均分为两组,对照组(19例)予以阿司匹林治疗,治疗组(37例)予以阿司匹林、氯吡格雷治疗,观察治疗90 d两组患者TIA复发、脑梗死事件、胃肠道反应、皮疹、脑出血的发生率。结果两组患者治疗90 d后,对照组TIA复发率为42.1%、治疗组TIA复发率为8.1%,治疗组显著低于对照组(P=0.004);对照组脑梗死发生率26.3%、治疗组脑梗死发生率5.4%,治疗组显著低于对照组(P=0.038)。对照组胃肠道反应发生率为10.5%、治疗组TIA复发率为8.1%,两组之间差异无统计学意义(P=0.557);对照组皮疹发生率为5.3%、治疗组皮疹发生率为8.1%,两组之间差异无统计学意义(P=0.582);两组患者均未发生脑出血。结论阿司匹林联合氯吡格雷治疗中高危TIA非心房纤颤患者是有效的,且是安全的。

Objective To observe the dual antiplatelet therapeutic effect and safety of aspirin clopidogrel in the transient ischemic attack（TIA） with non-atrial fibrilation. Methods Convenient selected 56 cases of patients with high risk of TIA with non atrial fibrillation were divided two groups from March 2011 to May 2015 in our hospital. They were control group（19cases） and treatment group（37cases）. Control group was administered aspirin. Dual antiplatelet therapy with aspirin and clopidogrel was administered in treatment group. The primary outcome was rate of recurrence of TIA, cerebral infarction,gastrointestinal tract reaction, erythra, and cerebral hemorrhagic during 90 days. Results Rate of recurrence of TIA was42.1% in control group, as compared with 8.1% in treatment group（P=0.004）. Rate of cerebral infarction was 26.3% in control group, as compared with 5.4% in treatment group（P=0.038）. Rate of gastrointestinal tract reaction was 10.5% in control group, as compared with 8.1% in treatment group,the difference was statistically significant（P=0.557）. Rate of erythra was 5.3% in control group, as compared with 8.1% in treatment group,the difference was statistically significant（P=0.582）.There were no occurrence of cerebral hemorrhagic in two groups. Conclusion Dual antiplatelet therapy was effective and safe in midst and high-risk TIA patients with non-atrial fibrilation.