CAJ | 학술논문

目的：观察国产氢氯吡格雷（泰嘉）在脑血管支架成形术（CAS）围手术期应用的疗效和安全性。方法入选拟行脑血管支架成形术的患者共20例，所有患者至少于术前7 d予以国产氢氯吡格雷，75 mg/天，术后继续口服3个月，期间均合用拜阿斯匹灵肠溶片（阿司匹林）200 mg/晚。观察3个月随访期内有无心脑血管事件及药物不良反应发生。结果20例患者中，共置入支架24枚，手术成功率100%。用药后3个月与入组时相比较，FBG、LDL-C、CRP、Fg均有所下降，差异具有统计学意义（P＜0.05）；白细胞计数、血肌酐有所升高，血小板计数稍降低，血ALT、AST稍有升高，差异无统计学意义。用药后3个月平均NIHSS评分与入组时相比显著下降，差异具有统计学意义（8.64±2.22 vs 4.54±2.78，P=0.004）；3个月随访时mRS评分（1.60±0.78），大部分患者神经功能恢复良好（mRS≤2分，16/20，80%）。围手术期发生短暂性脑缺血发作（TIA）1例。术后随访期间发生肝功能轻度受损2例，皮肤瘙痒1例，无其他心脑血管事件及药物不良反应发生。结论国产氢氯吡格雷用于CAS围手术期疗效可靠，安全性良好，可以作为CAS围手术期与阿司匹林联合抗血小板治疗的药物。
목적：관찰국산경록필격뢰（태가）재뇌혈관지가성형술（CAS）위수술기응용적료효화안전성。방법입선의행뇌혈관지가성형술적환자공20례，소유환자지소우술전7 d여이국산경록필격뢰，75 mg/천，술후계속구복3개월，기간균합용배아사필령장용편（아사필림）200 mg/만。관찰3개월수방기내유무심뇌혈관사건급약물불량반응발생。결과20례환자중，공치입지가24매，수술성공솔100%。용약후3개월여입조시상비교，FBG、LDL-C、CRP、Fg균유소하강，차이구유통계학의의（P＜0.05）；백세포계수、혈기항유소승고，혈소판계수초강저，혈ALT、AST초유승고，차이무통계학의의。용약후3개월평균NIHSS평분여입조시상비현저하강，차이구유통계학의의（8.64±2.22 vs 4.54±2.78，P=0.004）；3개월수방시mRS평분（1.60±0.78），대부분환자신경공능회복량호（mRS≤2분，16/20，80%）。위수술기발생단잠성뇌결혈발작（TIA）1례。술후수방기간발생간공능경도수손2례，피부소양1례，무기타심뇌혈관사건급약물불량반응발생。결론국산경록필격뢰용우CAS위수술기료효가고，안전성량호，가이작위CAS위수술기여아사필림연합항혈소판치료적약물。
Objective To observe safety and effectiveness of domestic hydrogen clopidogrel (Tai-jia) in perioperative patients with carotid angioplasty and stenting (CAS).Methods20 patients who would undergo CAS were enrolled in this study. All patients were given Tai-jia at a dose of 75 mg per day for at least 7 days prior to the operation, followed by 75 mg per day for 3 months. All the participants received aspirin at a dose of 75 mg during the study period. Cardio-cerebrovascular events and side effects were observed during the 3-month follow-up period.Results Of 20 patients enrolled, 24 stents were placed. The successful rate of operation was 100%. There were statistically signifi cant differences in FBG, LDL-C, CRP and Fg between the origin and end of the follow-up period (P<0.05). However, no signifi cant differences in white blood cell counts, serum creatinine, platelet counts, ALT and AST; In addition, there were statistically significant differences in NIHSS score (8.64±2.22 vs 4.54±2.78,P=0.004), and most patients recovered well at the end of the follow-up period (mRS 1.60±0.78, mRS≤2, 80%). 1 case was defi ned as TIA during the perioperative period. 2 cases of mild liver dysfunction and 1 case of itch were found during the study period. There were no cardio-cerebrovascular events and adverse drug reactions.Conclusion The safety and effectiveness of domestic hydrogen clopidogrel (Tai-jia) are satisfactory in perioperative patients with CAS, and the combination antiplatelet therapy of Tai-jia with aspirin can be used in perioperative period of CAS.