国产氯吡格雷联合倍他司汀、金纳多注射液治疗椎基底动脉供血不足所致眩晕的临床疗效分析

A Randomized Clinical Study of Clopidogrel,Betahistinel and Ginaton Injection in Treatment of Vertigo of VBI

目的 评价国产氯吡格雷联合倍他司汀、金纳多注射液治疗椎基底动脉供血不足(VBI)所致眩晕的有效性与安全性.方法 94例VBI患者,随机分为治疗组48例,给予国产氯吡格雷联合倍他司汀、金纳多注射液治疗.对照组给予倍他司汀、金纳多注射液治疗.两组连续治疗7～21d后评估患者的起效时间、临床疗效.采用TCD检测椎基底动脉血流速度并检测患者的血液流变学指标.同时随访30d记录患者发生TIA或脑梗塞人数及不良反应发生情况.结果 治疗组0～2h起效(47.7％vs26.1％)的患者及0～6h起效(87.4％vs56.1％)的患者占比率显著高于对照组,治疗组显效率(64.8％vs43.4％)、总有效率(93.7％vs78.2％)均明显高于对照组,两组比较具有统计学差异(P＜0.05).TCD检测显示,治疗组左侧椎动脉(43.3±4.5vs41.7±4.8)、右侧椎动脉(43.4±10.8vs41.4±10.7)、基底动脉(44.9±10.8vs42.8±11.2)的血流速度改善更为明显.两组比较具有统计学差异(P＜0.05).治疗组30d内0例发生TIA或脑卒中,对照组5例发生TIA,0例进展为脑卒中.两组比较具有统计学差异(x2=4.418,P=0.036).治疗过程,两组均未发生明显的不良事件.结论 国产氯吡格雷联合联合倍他司汀、金纳多注射液可显著改善椎基底动脉供血不足所致眩晕。

Objective To evaluate the efficacy of clopidogrel betahistine, ginaton injection in the treatment of vertebral basilar insufficiency(Vertebral-basilar artery insufficiency VBI) induced vertigo efficacy and safety. Methods 94 cases of VBI patients were randomly divided into a treatment group of 48 patients received clopidogrel domestic betahistine, ginaton Injection. The control group received betahistine, ginaton Injection. Two consecutive assessments onset of treatment,the patient's clinical efficacy after 7~21d. Vertebrobasilar using TCD detector detects blood flow velocity and blood rheology of patients. 30 d while recording the follow-up in patients with TIA or cerebral infarction size and adverse events. Results The treatment group was 0 ~2h onset(47.7% vs26.1%) of the patients and 0~6h onset(87.4% vs56.1%) of the patients was significantly higher as a percentage of the treatment group was efficiency(64.8% vs43.4%), total efficiency(93.7% vs78.2%) were significantly higher, with a significant difference between the two groups(P<0.05). TCD examination showed the left vertebral artery treatment group(43.3±4.5 vs 41.7±4.8),right vertebral artery(43.4±10.8 vs 41.4±10.7),basilar artery(44.9±10.8 vs 42.8±11.2) in the blood flow rate improved more significantly. A significant difference between the two groups(P <0.05).The treatment group 30 d 0 cases of TIA or stroke,the control group five cases occurred TIA, 0cases developed into stroke.A significant difference between the two groups(χ2=4.418,P=0.036).The course of treatment, both groups were not significant adverse events. Conclusion Domestic clopidogrel combined betahistine,ginaton injection can significantly improve vertebrobasilar insufficiency caused by vertigo, adverse reactions rarely occur during treatment