氯吡格雷联合阿司匹林对缺血性脑血管病二级预防的作用

Clopidogrel in combination with aspirin for secondary prevention of ischemic cerebrovascular disease

目的探讨氯吡格雷联合阿司匹林对缺血性脑血管病二级预防的作用。方法将140例经临床诊断为缺血性脑血管病的患者随机性地均分为对照组与观察组,各70例。对照组给予100 mg/d阿司匹林,观察组在此基础上给予75 mg/d氯吡格雷。两组患者根据实际的血压及血脂状况,给予20 mg/d阿托伐他汀及其相关的降压药物。比较治疗后两组患者的近、远期疗效,以及随访过程中心脑血管事件发生率以及不良反应发生情况等。结果1观察组患者近期与远期疗效明显优于对照组(P<0.05);2随访中,观察组仅出现1例脑出血症状,对照组1例脑出血、1例急性心梗(AMI)、3例脑梗死及2例短暂性脑缺血发作(TIA),心脑血管疾病的发生率明显高于观察组(P<0.01);3两组药物不良反应发生率不存在统计学差异(P>0.05)。结论氯吡格雷联合阿司匹林对症状性颅内动脉狭窄患者心脑血管事件二级预防较单用阿司匹林显著,应在临床上加以推广并应用。

Objective To investigate the role of clopidogrel in combination with aspirin for secondary prevention of ischemic cerebrovascular disease. Methods 140 patients with a clinical diagnosis of patients with ischemic cerebrovaseular disease were randomly divided into the control group and the observation group, and each group was 70 eases. The control group was given 100 mg/d of aspirin, and the observation group was given 75 mg/d clopidogrel on basis of the control group. According to the actual status of blood pressure and blood lipids, the two groups were given 20 mg/d atorvastatin statins and its related antihypertensive drugs. Compare the patients close, long-term efficacy, and cerebrovaseular event rate, adverse reactions after treating during follow- up. Results The observation of patients immediate and long-term efficacy was significantly better than the control group＇ s （P 〈 0.05 ） ; During the following- up, only patients with symptoms of cerebral hemorrhage appeared in the observation group, and one case of brain hemorrhage, one case of acute myocardial infarction （AMI）, 3 patients with cerebral infarction and two cases of TIA appeared in the control group, and the incidence of cardiovascular disease in the control group was significantly higher than the observation group （P 〈 0.01 ） ; the two groups The incidence of adverse drug reactions had no significant difference between the two groups （P 〈 0.05）. Conclusion Comparing with the single-using aspirin, the clopidogrel aspirin for symptomatic intracranial arterial stenosis could prevent the secondary cardiovascular and cerebrovascular events, and the adverse reactions were very lower.