氯吡格雷联合小剂量尿激酶治疗短暂性脑缺血发作的临床研究

Effect of Clopidogrel Combined with Small Dose of Urokinase on Patients with Transient Ischemic Attack

目的探讨氯吡格雷联合小剂量尿激酶治疗短暂性脑缺血发作的效果及安全性。方法选取2014年3月2017年5月阜新市第五人民医院神经内科收治的短暂性脑缺血发作（TIA）患者100例，按治疗方法的不同分为治疗组40例，采用氯吡格雷（泰嘉）联合小剂量尿激酶；双抗组60例，采用氯吡格雷（泰嘉）联合阿司匹林（拜阿斯匹灵）。比较两组治疗2d、7d、90d治愈率，用药前及7d后活化的部分凝血活酶时间（APTT）、血浆凝血酶原时间（PT）和纤维蛋白原（Fib）间的差异。结果治疗组治疗2d、7d、90d有效率分别为70％、92．5％-97．5％，高于双抗组48．3％、80％~90％。两组治疗48h的有效率差异有统计学意义（P〈0．05）。治疗组治疗后凝血时间无明显变化，纤维蛋白原较双抗组降低差异有统计学意义（P〈0．05）。结论应用氯吡格雷联合小剂量尿激酶治疗TIA起效更快，效果好，安全性高。早期应用可防止脑梗死的发生。

Objective To observe the effect and safety of clopidogrel combined with mall dose of urokinase in treating transient ischemic attack （TIA） patients. Methods A total of 100 TIA patients were collected in Department of Neurology, Fuxin Fifth People＇s Hospital from March, 2014 to May, 2017. According to therapy methods, the patients were divided into treatment group （n=40） and double resistant group （n=60）. The patients in treatment group received clopidogrel combined with mall dose of urokinase, while the patients in double resistant group received clopidogrel combined with aspirin. The cure rate at 2 day, 7 day and 90 day treatment, and activated partial thromboplastin time （APTT）, prothrombin time （PT） and fibrinogen （Fib） between before treatment and 7 day treatment were compared between two groups. Results The effective rates at 2 day, 7 day and 90 day treatment in treatment group were 70%,92.5% and 97.5%, respectively, and higher than 48.3%, 80% and 90% in double resistant group. Especially, at 48 hour treatment （2 day）, there was significant difference between two groups （P〈0.05）. Fib in treatment group was significantly lower than that in double resistant group （P〈0.05）, but APTT and PT have no significant changes after urokinase treatment. Conclusion The clopidogrel combined with mall dose of urokinase has fast function, good effect and high safety, and early application is helpful to prevent cerebral infarction.