摘要
目的:探讨微栓子监测评价缺血性卒中患者抗凝或抗血小板聚集药物的治疗效果。方法:75例发病1周内经CT或MRI证实的缺血性卒中患者入选本试验组。常规TCD检查后,进入TCD8.0微栓子监测软件,取双侧大脑中动脉(MCA)作监测血管,监测时间为40min。对微栓子监测阳性的患者,在常规治疗脑梗死药物的基础上加用抗凝药物(速碧林)或抗血小板聚集药物(力抗栓)治疗,分别在治疗前及治疗后第3、5、7、10天进行微栓子监测,观察药物治疗对微栓子的影响。结果:微栓子监测14例(18.7%)阳性;抗凝组(7例)和抗血小板聚集组(7例)治疗后第3、5、7、10天,MES明显低于治疗前(P<0.05);治疗后第5天,抗凝组MES的下降率高于抗血小板聚集组(P<0.05)。结论:抗凝或抗血小板聚集药物可以抑制MES的产生,而抗凝药物降低微栓子的作用比抗血小板聚集药物起效快;MES监测可作为评价抗凝或抗血小板聚集药物治疗是否有效的一项检测指标。
Objective: To investigate the effect of anticoagulants and anti-platelet agent in ischemic stroke patients evaluated by microembolic signal monitoring. Methods: Seventy-five acute cerebral infarction patients confirmed by cranial CT scan or MRI were enrolled in this study. After the patients were routinely examined with TCD. TCD 8.0 software was performed to detect microembolic signals(MES) in bilateral middle cerebral arteries(MCA), monitoring time was 40 minutes. For MES positive patients, they were treated with anticoagulants(Fraxiparine) or anti-platelet agents(Ticlopidine), MES were monitored with TCD at different time after treatment. Effect of anticoagulants or anti-platelet agents on MES were observed. Results: Among 75 patients, MES were detected in 14 patients(18.7%). Seven patients were administered with anticoagulants, the others with anti-platelet agents. Both the anticoagulants and the anti-platelet agents can reduce MES, the effect of anticoagulants in decreasing MES was better and faster than that of anti-platelet agents. Conclusion: Therapy either in anticoagulants or in anti-platelet agents may all reduce MES, MES monitoring is helpful to evaluate the effect of anticoagulants or anti-platelet agents.
出处
《中国临床医学影像杂志》
CAS
2004年第6期306-308,共3页
Journal of China Clinic Medical Imaging
