两种抗血小板方案治疗反复TIA的疗效比较研究

A comparative study of the efficacy of two anti-platelet regimen of recurrent TIA

目的对比分析两种抗血小板治疗方案在反复短暂性脑缺血发作(transient ischemic attack,TIA)患者中的应用价值。方法选取2015年6月~2017年6月收治的反复TIA发作患者90例为研究对象,以随机数字表法分为A组45例、B组45例。A组早期给予替罗非班,后续采用阿斯匹林联合氯吡格雷治疗,B组给予阿斯匹林联合氯吡格雷治疗,观察两组患者治疗后3 d、7 d内TIA复发次数,治疗前后卒中发生风险及治疗期间不良反应发生率、脑梗死发生率、血小板聚集率。结果 A组治疗后3 d、7 d内TIA复发次数同B组比较,明显较少,差异有统计学意义(P<0.05);治疗前两组ABCD2、ESRS评分无显著差异(P>0.05),治疗后均有改善,A组治疗后ABCD2、ESRS评分同B组比较,明显较低,差异有统计学意义(P<0.05);A组治疗期间不良反应发生率为6.67%,脑梗死发生率为11.11%,同B组的22.22%、28.89%比较,明显较低,差异有统计学意义(P<0.05);A组治疗后血小板聚集明显低于B组,差异有统计学意义(P<0.05)。结论替罗非班抗血小板在反复TIA治疗中应用,可获得更好疗效,并能减少不良反应,更值得推广。

Objective To compare and analyze the value of two kinds of antiplatelet therapy in patients with recurrent transient ischemic attack （TIA）. Methods Totally 90 patients with recurrent TIA who were admitted in our hospital from June 2015 to June 2017 were selected and divided into group A（n=45） and group B（n=45） by random number table. The group A was given tirofiban at an early stage and subsequent use of aspirin combined with clopidogrel treatment. The group B was given aspirin combined with clopidogrel treatment. The number of TIA relapse within 3 d, 7 d after treat- ment, the risk of stroke before and after treatment and adverse reactions during treatment, the incidence of cerebral in- farction and platelet aggregation rate between the two groups of patients were observed. Results The number of TIA re- currence in group A was significantly less than that in group B within 3 d and 7 d after treatment, and there was sig- nificant difference between the two groups（P〈0.05）. There was no significant difference in ABCD2 and ESRS scores be- tween the two groups before treatment（P〉0.05）. After treatment, ABCD2 and ESRS scores improved in both groups. The ABCD2 and ESRS scores in group A were significantly lower than those in group B after treatment（P〈0.05）. The incidence of adverse reactions in group A was 6.67%, the incidence of cerebral infarction was 11.11%, which was significantly lower than that（22.22% and 28.89%, respectively） in group B, and the difference was significant（P〈0.05）. The platelet aggregation in group A was significantly lower than that in group B after treatment, and the difference was significant （/9〈0.05）. Conclusion The application of tirofiban antiplatelet in the treatment of repeated TIA can achieve better cura- tive effect, reduce adverse reactions and is more worthy of promotion.