【摘要】 目的对比强化抗血小板聚集治疗与阿托伐他汀联合阿司匹林在缺血性脑卒中(CAT)复发高危患者二级预防中的应用效果。方法选取符合CAT复发高危诊断标准的146例患者作为研究对象,采用随机抽签方式均分为2组,2组均接受常规治疗,对照组在此基础上给予阿司匹林及氯吡格雷,观察组则给予阿司匹林及阿托伐他汀进行治疗。对比2组不同时期抗血小板聚集率与血脂指标总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)的变化情况,并记录2组患者随访期间复发率与不良反应情况。结果 2组在治疗1周与治疗后3个月、6个月时的血小板聚集率均较治疗前显著下降(P <0. 05),而对照组在治疗1周时的下降幅度大于观察组(P <0. 05),但治疗后3个月、6个月时2组间血小板聚集率差异无统计学意义(P> 0. 05);对照组治疗1周、治疗后3个月、6个月的TC水平均显著降低,TG治疗后3个月、6个月显著低于治疗前,LDL-C在治疗后6个月显著低于治疗前(P <0. 05);治疗1周与治疗后3个月、6个月时,观察组的3项血脂水平均显著低于治疗前(P <0. 05),且显著低于对照组(P <0. 05);出院随访3个月时2组CAT高危患者复发率差异无统计学意义(P> 0. 05),但随访12个月时观察组高危患者复发率显著低于对照组(P <0. 05);观察组治疗1周与治疗后3个月、12个月的不良反应发生率显著低于对照组(P <0. 05)。结论 CAT复发高危患者长期使用阿托伐他汀与阿司匹林进行二级预防的治疗效果显著优于强化抗血小板聚集治疗,可显著降低患者复发率,且安全性高。更多还原

【Abstract】 Objective To compare the effect of intensive antiplatelet aggregation therapy versus atorvastatin combined with aspirin in secondary prevention of high risk patients with ischemic stroke( CAT) recurrence. Methods A total of 146 patients who met the high-risk diagnostic criteria for CAT recurrence were included in the study,and were divided into two groups by random lottery.Both groups received routine treatment. The control group was given aspirin and clopidogrel for treatment,while the observation group was treated with aspirin and atorvastatin. The changes of antiplatelet aggregation rate,blood lipid indicators such as total cholesterol( TC),triacylglycerol( TG) and low-density lipoprotein( LDL-C) in different periods were compared. The recurrence rate and adverse reactions during follow-up period were recorded. Results The platelet aggregation rate of the two groups decreased significantly at 1 week,3 months and 6 months of treatment than treatment before(P < 0. 05). The decrease of the control group was slightly larger than that of the observation group at1 week( P < 0. 05). However,there was no significant difference in platelet aggregation rate between the two groups at 3 months and 6 months after treatment( P > 0. 05). The TC levels in the control group were significantly decreased after 1 week,3 months and 6 months of treatment,the level of TG after 3 months and 6 months of treatment were significantly lower than treatment before,the level of LDL-C after 6 months of treatment was significantly lower than treatment before( P < 0. 0 5). The blood lipid levels of the observation group at 1 week and 3 months and 6 months after treatment were significantly lower than treatment before and control group( P < 0. 05). There was no significant difference in recurrence rate of high-risk patients with CAT at 3 months after discharge( P > 0. 05).However,the recurrence rate of the high-risk patients in the observation group was significantly lower than that of the control group at 12 months follow-up,and the incidence of adverse reactions in the observation group at 1 week and at 3 months and 12 months after treatment was significantly lower than that in the control group( P < 0. 05). Conclusion Long-term use of atorvastatin and aspirin for CAT recurrence is significantly better than secondary anti-platelet aggregation therapy,which can significantly reduce the recurrence rate,and improve safety.更多还原