摘要
目的比较颈动脉夹层（CAD）抗凝与抗血小板治疗的效果。方法 48例CAD患者分为抗凝组和抗血小板组,每组24例。抗凝组根据患者实际情况服用3-6个月华法林,抗血小板组采用阿司匹林100 mg/d＋氯吡格雷75 mg/d治疗3-6个月。两组患者均以任何原因的卒中复发、出血性事件或者死亡作为观察终点事件,随访时间为1a。结果抗凝组有22例（91.7%）未出现终点事件,2例出现卒中复发,其中1例接受支架植入术治疗。抗血小板组有15例（62.5%）未发生终点事件,3例出现卒中复发,5例出血以及1例死亡。抗凝组临床疗效明显优于抗血小板组,差异有统计学意义（χ^2=5.779,P〈0.05）。两组患者出院时的美国国立卫生院卒中量表（NIHSS）评分均显著优于人院时（P〈0.01）,但两组间比较差异则无统计学意义（P〉0.05）。随访期间两组患者均无缺血性及出血性事件发生。结论抗凝和抗血小板治疗CAD均有效,且抗凝治疗的效果优于抗血小板治疗,值得临床推广。
Objective To investigate the effect of antiplatelet and anticoagulation in the treatment of carotid artery dissection （CAD）. Methods 48 cases with CAD received and treated the First People＇s Hospital of Shunde from July 2010 to June 2015 were selected and randomly divided into two groups： Ancoagulation Group and Antiplatelet Group, 24 cases in each group. Ancoagulation Group was administered with warfarin for 3-6 months based on actual situation of the patients while Antiplatelet Group was administered with 100mg/d aspirin ＋ 75mg/d clopidogrel for 3-6 months. For both groups, stroke recurrence, hemorrhage event or death of any reason shall be taken as endpoint event of the observation, and the follow-up time was 1 a. Results Of 24 eases of Anticoagulation Group, 22 cases （91.7%） had no endpoint event, 2 cases had stroke recurrence, of which 1 case received stent implantation. Of 24 cases of Antiplatelet Group, 15 cases （62.5%） had no endpoint event, 3 cases had stroke recurrence, 5 cases had bleeding and 1 case died. The clincal efficacy of Anticoagulation Group was significantly superior to that of Antiplatelet Group, and the difference was statistically significant （Х^2 =5.779, P〈0.05）. For both groups, the NIHSS score at discharge was significantly superior to that before treatment （P〈0.01）, but there was no significant statistical difference between the two groups （P〉0.05）. Conclusion Both Antiplatelet Group and Anticoagulation Group were effective in treating CAD, and anticoagnlation treatment is better than antiplatelet treatment in terms of therapeutic effect, which is worth clinical promotion.
出处
《广东医学院学报》
2016年第3期308-311,共4页
Journal of Guangdong Medical College
关键词
颈动脉夹层
抗凝治疗
抗血小板治疗
carotid artery dissection
anticoagulation therapy
antiplatelet therapy
