拜阿司匹林、硫酸氢氯吡格雷联合低分子肝素治疗后循环缺血的临床效果和安全性观察

目的 观察拜阿司匹林、硫酸氢氯吡格雷联合低分子肝素治疗后循环缺血（PCI）的疗效及安全性.方法 选择淄博市第七人民医院2012年6月～2013年1月收治的PCI患者100例,随机分为治疗组及对照组,对照组50例给予拜阿司匹林治疗,治疗组50例在此基础上加用硫酸氢氯吡格雷及低分子肝素治疗,两组患者的疗程均为3周,并随访2个月.治疗后3周根据临床症状和经颅多普勒（TCD）评价效果,治疗后2个月比较两组患者的血小板计数、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）及出血等不良反应情况.结果 治疗3周,治疗组患者的总有效率为94.0％,对照组为66.0％,治疗组的总有效率高于对照组,两组比较差异有统计学意义（P＜0.05）,治疗过程中及治疗后2个月两组均未见出血等不良反应.结论 拜阿司匹林、硫酸氢氯吡格雷联合低分子肝素治疗后循环缺血的效果显著,安全可行,值得推广.

Observe the clinical efficacy and safety of aspirin,ciopidogrel sulfate combined with low molecular weight heparin in the treatment of posterior circulation ischemia

Objective To observe the efficacy and safety of aspirin,clopidogrel sulfate combined with low molecular weight heparin in the treatment of posterior circulation ischemia. Methods 100 patients with posterior circulation ischemia in Seventh People＇s Hospital of Zibo City from 2012 June to 2013 January were selected and randomly divided into treatment group and control group,50 cases in the control group were given aspirin therapy,50 cases in the treatment group were given clopidogrel sulfate and low molecular weight heparin therapy on the basis of the control group, two patients were treated for 3 weeks,and were followed up for 2 months.3 weeks after the treatment evaluated the result according to the clinical symptoms and transcranial Doppler （TCD）,the platelet count,fibrinogen （FIB）,activated par- tial thromboplastin time （APTY） and bleeding and other adverse reactions in 2 months after treatment were compared. Results After treatment 3 weeks,the total effective rate of treatment group was 94%,the control group was 66.0%,the total effective rate of treatment group was higher than that of the control group,there was significant difference between the two groups （P〈0.05）,in the course of treatment and 2 months after treatment in two groups were no adverse reactions such as bleeding. Conclusion The effect of aspirin,clopidogrel sulfate combined with low molecular heparin in the treatment of posterior circulation ischemia is significant,safety is feasible,it is worth popularizing.