中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
12期
1126-1127
,共2页
脑缺血发作,短暂性%阿托伐他汀%阿司匹林%氯吡格雷%颈动脉%支架
腦缺血髮作,短暫性%阿託伐他汀%阿司匹林%氯吡格雷%頸動脈%支架
뇌결혈발작,단잠성%아탁벌타정%아사필림%록필격뢰%경동맥%지가
Ischemic attack,transient%Atorvastatin%Aspirin%Clopidogrel%Carotid arteries%Stents
目的 观察颈动脉系统短暂性脑缺血发作(TIA)支架成形术后长期联合应用阿托伐他汀钙、阿司匹林肠溶片和氯吡格雷的疗效及安全性.方法 将42例颈动脉支架成形术后的颈动脉系统TIA患者,采用随机数字表法随机分为3组,每组14例,A组应用氯吡格雷75 mg/d,3个月;B组氯吡格雷75 mg/d,6个月;C组氯吡格雷75 mg/d,12个月.3组患者阿司匹林肠溶片100mg/d,阿托伐他汀钙20 mg/次,每晚1次,长期应用.支架成形术后1、3、6及12个月均复查颈动脉超声、经颅多普勒或脑血管造影,比较3组患者主要脑血管病(脑血管性死亡、脑栓塞)及出血等不良事件的发生率.结果 A组有效率为71.4%(10/14),发生1例与狭窄部位有关的脑栓塞,3例血管再狭窄,无严重出血;B组有效率为100%(14/14),C组为64.3%(9/14),B组及C组尚未观察有脑栓塞的发生.C组1例出现上消化道大出血,1例轻度的消化道出血,3例出现皮肤淤斑及牙龈出血.3组患者均未出现明显的肝功能及肌肉的损害.结论 颈动脉系统TIA支架后长期联合应用阿托伐他汀钙、阿司匹林肠溶片和氯吡格雷是安全、有效的,可减少脑血管事件的发生,出血并发症随用药时间的延长亦相应增加.
目的 觀察頸動脈繫統短暫性腦缺血髮作(TIA)支架成形術後長期聯閤應用阿託伐他汀鈣、阿司匹林腸溶片和氯吡格雷的療效及安全性.方法 將42例頸動脈支架成形術後的頸動脈繫統TIA患者,採用隨機數字錶法隨機分為3組,每組14例,A組應用氯吡格雷75 mg/d,3箇月;B組氯吡格雷75 mg/d,6箇月;C組氯吡格雷75 mg/d,12箇月.3組患者阿司匹林腸溶片100mg/d,阿託伐他汀鈣20 mg/次,每晚1次,長期應用.支架成形術後1、3、6及12箇月均複查頸動脈超聲、經顱多普勒或腦血管造影,比較3組患者主要腦血管病(腦血管性死亡、腦栓塞)及齣血等不良事件的髮生率.結果 A組有效率為71.4%(10/14),髮生1例與狹窄部位有關的腦栓塞,3例血管再狹窄,無嚴重齣血;B組有效率為100%(14/14),C組為64.3%(9/14),B組及C組尚未觀察有腦栓塞的髮生.C組1例齣現上消化道大齣血,1例輕度的消化道齣血,3例齣現皮膚淤斑及牙齦齣血.3組患者均未齣現明顯的肝功能及肌肉的損害.結論 頸動脈繫統TIA支架後長期聯閤應用阿託伐他汀鈣、阿司匹林腸溶片和氯吡格雷是安全、有效的,可減少腦血管事件的髮生,齣血併髮癥隨用藥時間的延長亦相應增加.
목적 관찰경동맥계통단잠성뇌결혈발작(TIA)지가성형술후장기연합응용아탁벌타정개、아사필림장용편화록필격뢰적료효급안전성.방법 장42례경동맥지가성형술후적경동맥계통TIA환자,채용수궤수자표법수궤분위3조,매조14례,A조응용록필격뢰75 mg/d,3개월;B조록필격뢰75 mg/d,6개월;C조록필격뢰75 mg/d,12개월.3조환자아사필림장용편100mg/d,아탁벌타정개20 mg/차,매만1차,장기응용.지가성형술후1、3、6급12개월균복사경동맥초성、경로다보륵혹뇌혈관조영,비교3조환자주요뇌혈관병(뇌혈관성사망、뇌전새)급출혈등불량사건적발생솔.결과 A조유효솔위71.4%(10/14),발생1례여협착부위유관적뇌전새,3례혈관재협착,무엄중출혈;B조유효솔위100%(14/14),C조위64.3%(9/14),B조급C조상미관찰유뇌전새적발생.C조1례출현상소화도대출혈,1례경도적소화도출혈,3례출현피부어반급아간출혈.3조환자균미출현명현적간공능급기육적손해.결론 경동맥계통TIA지가후장기연합응용아탁벌타정개、아사필림장용편화록필격뢰시안전、유효적,가감소뇌혈관사건적발생,출혈병발증수용약시간적연장역상응증가.
Objective To observe the efficacy and safety of combined therapy with lipitor, aspirin and clopidogrel after carotid artery stenting in patients with the carotid system transient ischemic attack (TIA). Methods Forty-two cases of carotid artery stenting of the carotid arterial system TIA patients were randomly divided into three groups with 14 cases in each group: the first group with clopidogrel 75 mg/d for 3 months; the second group with clopidogrel 75 mg/d for 6 months and the third group with clopidogrel 75 mg/d for 12 months. Three groups of patients had aspirin 100 mg/d, lipitor 20mg/qn. At 1,3,6 and 12 months after stenting, carotid artery ultrasound,transcranial doppler or DSA was done and major cerebrovascular disease ( cerebral vascular death, cerebral embolism) were then compared. The occurrence rate of major cerebralvascular events and adverse reactions were observed. Results In the first group,1 case had cerebral embolism with the narrow part,3 cases had restenosis. Cerebral embolism was not observed in the second group and the third group. 1 patients had upper gastrointestinal bleeding in the third group. 1 patients had mild gastrointestinal bleeding. 3 cases had skin ecchymosis and bleeding gums.There was no liver function and muscle damage. Conclusions Long-term combined administration of lipitor,aspirin and clopidogrel is safe and effective in carotid artery stenting of TIA. It helps reduce the occurrence of cerebralvascular events after carotid artery stenting operation. But the bleeding complication with the drug also correspondingly increases.
