活血化瘀中药对颈动脉粥样硬化及缺血性脑血管事件的影响

目的探讨活血化瘀中药对颈动脉粥样硬化斑块及远期缺血性脑血管事件的影响。方法采用开放、对照的研究方法，分析血小板拮抗剂、血小板拮抗剂＋活血化瘀中药、血小板拮抗剂＋阿托伐他汀、血小板拮抗剂＋阿托伐他汀＋活血化瘀中药4类药物组合对90例脑梗死患者颈动脉硬化斑块及远期缺血性脑血管事件的影响。结果通过生存分析发现，4种药物干预组合对颈动脉狭窄率变化值及缺血性脑血管事件的影响无统计学意义（P〉0．05）；活血化瘀中药参与组较无活血化瘀中药参与组延长缺血性脑血管意外事件的发生时间约4个月。通过多因素Logistic分析发现，年龄、高血压、氯吡格雷与颈动脉颅外段狭窄变化情况有关（P〈0．05）；年龄、糖尿病、阿司匹林、氯吡格雷、活血化瘀中药与脑血管意外事件的发生有关（P〈0．05）。结论是否伴有高血压是对颈动脉狭窄变化产生影响的因素，但并不影响缺血性脑血管事件的发生，活血化瘀中药可以有效延长缺血性脑血管事件的发生时间。

Effect of Chinese Drugs for Activating Blood Circulation and Removing Blood Stasis on Carotid Atherosclerosis end Ischemic Cerebrovascular Events

Objective To explore the effect of Chinese drugs for activating blood circulation and removing blood stasis （CDABCRBS） on carotid atherosclerotic plaque and long-term ischemic cerebro- vascular events. Methods By using open and control method, effect of 4 groups of platelet antagonists, platelet antagonists ＋ CDABCRBS, platelet antagonists ＋ atorvastatin, platelet antagonists ＋ atorvastatin ＋CDABCRBS on carotid atherosclerotic plaque and long-term ischemic cerebrovascular events of 90 cerebral infarction patients were analyzed. Results Through survival analysis, there was no statistical difference in the effect of the 4 interventions on the variation of carotid stenosis rates or ischemic cere- brovascular events （P 〉0.05）. The occurrence of ischemic cerebrovascular events could be postponed by about 4 months in those treated with platelet antagonists ＋ CDABCRBS and platelet antagonists ＋ ator- vastatin ＋ CDABCRBS. By multivariate Logistic analysis, age, hypertension, and clopidogrel were asso- ciated with stenosis of extracranial carotid arteries （P 〈0.05）. Age, diabetes, aspirin, clopidogrel, CD- ABCRBS were correlated with cerebrovascular accidents （P 〈0.05）. Conclusions Whether or not ac- companied with hypertension is an influential factor for carotid stenosis, but it does not affect the occur- rence of ischemic cerebrovascular events. CDABCRBS could effectively prolong the occurrence time of ischemic cerebrovascular events.