替格瑞洛与阿司匹林对动脉粥样硬化性脑卒中患者神经功能及复发的影响

Effects of ticagrelor and aspirin on neurological function and recurrence in patients with atherosclerotic stroke

目的:观察替格瑞洛与阿司匹林对动脉粥样硬化性脑卒中后神经功能及复发的影响。方法:选取2016年6月至2017年6月在我院住院的符合实验条件的368例脑卒中患者,按照随机数字表法随机分为观察组及对照组,各184例,在发病24 h内,观察组给予替格瑞洛(第1 d负荷量180 mg,第2 d至180 d内90 mg·次-1,2次·d-1),对照组给予阿司匹林(第1 d负荷量300 mg,第2~180 d内100 mg·次-1,1次·d-1)治疗。比较两组患者发病后1个月、3个月、6个月神经功能恢复情况及复发的发生情况。结果:在发病1月后、3月后及6个月观察组的NIHSS评分较对照组相比明显降低,而复发的发生较对照组明显较少,有统计学意义(P<0.05)。在整个实验过程中,观察组失访3人,对照组失访1人,其他患者均获得有效随访。随访时间(6.38±1.20)个月。结论:较阿司匹林而言,替格瑞洛在改善动脉粥样硬化性脑卒中后神经功能及复发方面作用更明显,且在不增加副作用的前提下有效的降低患者短期内复发的发生率,其确切的疗效及良好的安全性值得临床进一步推广。

Objective：To observe the effects of ticagrelor and aspirin on neurological function and recurrence after atherosclerotic stroke.Methods：A total of 368 stroke patients who were enrolled in our hospital from June 2016 to June 2017 were selected.According to the random number table method,the patients were randomly divided into observation group and control group,184 in each,The control group received Ticagrelor（the first day load of180 mg,the second day to 180 th day 90 mg·time^-1,2 times·d^-1）,the control group given aspirin（the first day load of 300 mg,the second-180 th day 100 mg · time^-1,1 times · d^-1）treatment.The recovery of neurological function and the recurrence were observed at 1 month,3 months,and 6 months after the onset of the two groups.Results：The NIHSS score of the observation group was significantly lower than that of the control group after 1 month,3 months and 6 months,and the incidence of recurrence was significantly lower than that of the control group（P 〈 0.05）.During the whole experiment,the observation group lost 3 people,the control group lost 1 person,while other patients were effectively followed-up.Follow-up time（lasted 6.38 ± 1.20）months.Conclusion：Compared with aspirin,Ticagrelor is more effective in improving neurological function and avoiding relapse after atherosclerotic stroke,and it is effective to reduce the recurrence rate of short-term recurrence without increasing the side effect.The efficacy and good safety is worthy of further clinical further promotion.