西洛他唑联合阿司匹林及氯吡格雷对颈动脉狭窄患者神经介入后血栓影响及安全性分析

目的 探讨西洛他唑片联合阿司匹林肠溶片及硫酸氢氯吡格雷片对颈动脉狭窄患者神经介入后血栓影响及安全性。方法 选择2015年1月-2017年12月杨凌示范区医院收治的60例行神经介入治疗的颈动脉狭窄患者，根据随机数字表法，分为观察组及对照组。两组患者采用远端保护装置，根据病变血管的特征，选择合适的支架种类进行前后扩张。对照组患者口服阿司匹林肠溶片300 mg/次，1次/d，硫酸氢氯吡格雷片75 mg/次，1次/d；观察组在对照组基础上口服西洛他唑片200 mg/d，2次/d。两组疗程均为术前1周至术后6个月。观察两组患者治疗前后的血小板聚集率、血流动力学及血脂指标，观察两组治疗过程中的不良反应、缺血事件及缺血病灶例数。结果 治疗后，两组的血小板聚集率、红细胞压积、纤维蛋白原均明显下降，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后观察组均明显低于对照组，组间差异有统计学意义（P<0.05）。治疗后，两组的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均明显降低，高密度脂蛋白胆固醇（HDL-C）明显上升，同组治疗前后比较差异均有统计学意义（P<0.05）；且观察组明显优于对照组，组间差异均有统计学意义（P<0.05）。两组患者的不良反应无统计学意义；观察组的缺血事件及缺血病灶发生率明显低于对照组，差异有统计学意义（P<0.05）。结论 西洛他唑片联合阿司匹林肠溶片及硫酸氢氯吡格雷片三联疗法对颈动脉狭窄患者神经介入术后抗血栓作用较好，且不增加不良反应发生率。

Effect and safety of cilostazol combined with aspirin and clopidogrel on thrombosis after neurointervention in patients with carotid artery stenosis

Objective To investigate the effect and safety of Cilostazol Tablets combined with Aspirin Enteric-coated Tablets and Clopidogrel Hydrogen Sulphate Tablets on thrombosis after neurointervention in patients with carotid artery stenosis. Methods 60 cases with carotid artery stenosis after neurointervention in Yangling Demonstration Zone Hospital were chosen, who were divided into the observation group and control group according to random number table method. Patients in two groups were treated with distal protection device. According to the characteristics of the lesion vessels, appropriate stent types were selected for anterior and posterior dilatation. Patients in the control group were po administered with Aspirin Enteric-coated Tablets, 300 mg/time, once daily, and Clopidogrel Hydrogen Sulphate Tablets 75 mg/time, once daily. Patients in the observation group po administered with Cilostazol Tablets on the basis of control group, 200 mg/d, twice daily. Both groups were treated from 1 week before operation to 6 months after operation. The platelet aggregation rate, hemodynamics and blood lipids indexes in two groups before and after treatment, and the adverse reactions, ischemic events and ischemic lesions number were compared. Results After treatment, the platelet aggregation rate, hematocrit and fibrinogen in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observation group was significantly lower than the control group, with significant difference between two groups (P<0.05). After treatment, TC, TG, LDL-C in two groups were significantly decreased, HDL-C was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observation group was significantly better than the control group, with significant difference between two groups (P<0.05). There was no significant difference in adverse reactions between the two groups. The incidence of ischemic events and ischemic lesions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Cilostazol Tablets combined with Aspirin Enteric-coated Tablets and Clopidogrel Hydrogen Sulphate Tablets triple antiplatelet had better antithrombotic effects on thrombosis after neurointervention in patients with carotid artery stenosis, and which could not increase the adverse reactions incidence.