梁友云,马纯
LIANG Youyun,MA Chun

• 1:丰润区第二人民医院神经内科
• 2:丰润区中医医院

摘要(Abstract)：

目的:探讨盐酸替罗非班联合低分子肝素钙治疗短暂性脑缺血(TIA)发作的临床疗效。方法:TIA患者82例,随机均分为对照组和观察组,对照组应用司匹林肠溶片联合低分子肝素钙治疗,观察组TIA患者应用盐酸替罗非班注射液联合低分子肝素钙治疗,比较两组TIA患者治疗后临床疗效、不良反应、血小板内皮细胞黏附分子-1(PECAM-1)和血小板计数(PLT)、凝血酶原时间(PT)、活化部分促凝血酶原激酶时间(APTT)、纤维蛋白原(FIB)等凝血指标的变化。结果:观察组患者总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组TIA患者的凝血指标和PECAM-1比较,差异无统计学意义(P>0.05);治疗后,凝血指标差异亦无统计学意义(P>0.05),但观察组PECAM-1水平高于对照组,差异有统计学意义(P<0.05);两组均未见皮肤、黏膜、消化道出血等不良反应。结论:盐酸替罗非班联合低分子肝素钙治疗TIA发作临床疗效优于阿司匹林肠溶片联合低分子肝素钙。
Objective: To explore clinical effect of tirofiban hydrochloride combined with low molecular weight heparin calcium( LMWHC) in the treatment of transient ischemic attack( TIA). Methods:Eigihty-two patients with TIA were enrolled in this study,who were randomly divided into control group( 41 cases) and observation group( 41 cases). Aspirin enteric coated tablets combined with LMWHC was used in treatment of control group while tirofiban hydrochloride injection combined with LMWHC was used in treatment of observation group. The clinical effect,adverse reactions,the level of platelet endothelial cell adhesion molecule-1( PECAM-1) and the changes of blood coagulation indexes,including platelet count( PLT),prothrombin time( PT),activated partial thromboplastin time( APTT),fibrinogen( FIB) level were compared between observation group and control group. Results: The total effective rate of observation group was significantly higher than that of control group,and the difference was significant( P < 0. 05). Before treatment,there was no statistical differences of PLT,PT,APTT,FIB levels and PECAM-1 level between observation group and control group( P >0. 05). After treatment,there were no statistical differences of blood coagulation indexes between observation group and control group but PECAM-1 level in observation group was significantly higher than that of control group( P < 0. 05). There was no such adverse reactions as dermorrhagia,mucosal bleeding,gastrointestinal bleeding in two groups. Conclusion: Tirofiban hydrochloride combined with LMWHC is better than aspirin enteric coated tablets combined with LMWHC in the treatment of transient ischemic attack and worthy of further popularization and application.

关键词(KeyWords)： 盐酸替罗非班;低分子肝素钙;阿司匹林;短暂性脑缺血;凝血因子
tirofiban hydrochloride;low molecular weight heparin calcium;aspirin;transient ischemic attack;coagulation factors

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 梁友云,马纯
LIANG Youyun,MA Chun

DOI: 10.19367/j.cnki.1000-2707.2015.07.030

参考文献(References)：

• [1]陈锦艳,李雄新,王大成,等.青年短暂性脑缺血发作26例DSA分析[J].河北医学,2012(7):940-942.
• [2]李俊玉.关于短暂性脑缺血发作的最新认识[J].中国卒中杂志,2012(1):36-39.
• [3]姚少芳.交联共聚淀粉微球对阿司匹林吸附性能的研究[J].贵阳医学院学报,2011(2):124-127.
• [4]骆迪,毕齐.肢体抖动型短暂性脑缺血发作的研究进展[J].中国卒中杂志,2012(7):68-70.
• [5]Kernan WN,Ovbiagele B,Black HR,et al.Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack:a guideline for healthcare professionals from the American Heart Association/A mer ican St roke Association[J].Stroke,2014(45):2160-2236.
• [6]张金臣.盐酸法舒地尔治疗慢性脑供血不足临床疗效观察[J].贵阳医学院学报,2011(5):491-493.
• [7]胡奇华.阿司匹林联合低分子肝素治疗短暂性脑缺血发作疗效观察[J].中国实用神经疾病杂志,2014(15):301-303.
• [8]睿海.低分子肝素与普通肝素在脑血管病介入治疗中的应用效果观察[J].海南医学,2011(20):33-34.
• [9]李俊玉,毕齐.关于短暂性脑缺血发作的最新认识[J].中国卒中杂志,2012(1):36-39.
• [10]秦培英,禤彩霞.三联疗法治疗短暂性脑缺血发作的疗效观察[J].临床合理用药杂志,2013(5):67-68.

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