替格瑞洛联合阿托伐他汀钙治疗脑血栓患者的临床研究

Clinical trial of ticagrelor combined with atorvastatin calcium in the treatment of patients with cerebral thrombus

目的 观察替格瑞洛片联合阿托伐他汀钙片治疗脑血栓患者的临床疗效和安全性。方法 将脑血栓患者按队列法分为对照组和试验组。2组患者均给予基础治疗,在此基础上,对照组口服阿托伐他汀钙,每次20 mg,每天1次;试验组在对照组治疗的基础上,联合口服替格瑞洛,每次90 mg,每天2次。2组患者均治疗4个月。比较2组患者的临床疗效、神经功能、血液黏度、血小板参数与脑损伤标志物,以及药物不良反应的发生情况。结果 试验组入组119例,对照组入组117例。治疗后,试验组和对照组的总有效率分别为91.60%(109例/119例)和82.05%(96例/117例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组和对照组的美国国立卫生研究院卒中量表评分分别为(5.47±0.82)和(6.51±0.96)分,血浆黏度分别为(1.35±0.21)和(1.62±0.24)mPa·s,全血高切黏度分别为(3.67±0.51)和(4.01±0.59)mPa·s,全血低切黏度分别为(6.12±0.93)和(7.05±1.07)mPa·s,血小板黏附率分别为(30.52±3.81)%和(36.21±4.02)%,平均血小板体积分别为(12.75±1.86)和(15.42±2.06)fL,泛素羧基末端水解酶-1分别为(0.39±0.06)和(0.51±0.07)μg·L^(-1),衰老关键蛋白抗原-5分别为(90.76±12.23)和(81.64±11.95)μg·L^(-1),在统计学上差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均以恶心呕吐、出血、腹痛和腹泻为主。试验组和对照组的总药物不良反应发生率分别为5.04%和4.27%,在统计学上差异无统计学意义(P>0.05)。结论 替格瑞洛片联合阿托伐他汀钙片治疗脑血栓患者的临床疗效显著,其能显著改善患者的神经功能、血液黏度、脑损伤标志物、血小板参数水平,且不会增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of ticagrelor tablets combined with atorvastatin calcium tablets in the treatment of cerebral thrombosis.Methods The patients with cerebral thrombosis were divided into control group and treatment group according to cohort methods.Two groups were given basic therapy.On the basic therapy,control group was given atorvastatin calcium 20 mg per time,once a day,orally;on the basic of control group,the treatment group received ticagrelor 90 mg per time,twice a day,orally.Two groups were treated for 4 months.The clinical efficacy,nerve function,blood viscosity,platelet parameters,brain injury markers and adverse drug reactions were compared between two groups.Results Treatment and control groups enrolled 119 and 117 cases,respectively.After treatment,the total effective rates of treatment and control groups were 91.60%(109 cases/119 cases) and 82.05%(96 cases/117 cases) with significant difference(P<0.05).After treatment,the scale scores of treatment and control groups were (5.47±0.82) and (6.51±0.96)points;the plasma viscosity levels were (1.35±0.21) and (1.62±0.24) m Pa·s,whole blood high shear viscosity levels were (3.67±0.51) and (4.01±0.59) m Pa·s;the whole blood low shear viscosity levels were(6.12±0.93) and (7.05±1.07) m Pa·s;the platelet adhesion rates were (30.52±3.81)%and(36.21±4.02)%;the mean platelet volumes were (12.75±1.86) and (15.42±2.06) f L;the carboxy-terminal hydrolase of ubiquitin levels were (0.39±0.06) and (0.51±0.07)μg·L^(-1);the key protein antigen-5 of aging levels were (90.76±12.23) and (81.64±11.95)μg·L^(-1);and the differences were statistically significant between two groups (all P<0.05).The adverse drug reactions of two groups were nausea,vomiting,bleeding,abdominal pain and diarrhea.The total incidences of adverse drug reactions in treatment and control groups were 5.04%and 4.27%,without significant difference (P>0.05).Conclusion Ticagrelor tablets combined with atorvastatin calcium tablets have a significant clinical efficacy in the treatment of patients with cerebral thrombus,which can significantly improve the neurological function,blood viscosity,brain injury markers,and platelet parameters of patients,without increasing the incidence of adverse drug reactions.