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目的观察人尿激肽原酶与阿司匹林、氯吡格雷双抗血小板在降低高危非致残性缺血性脑血管事件(HR-NICE)患者90d内出现缺血性卒中风险的作用。方法 HR-NICE患者305例随机分为两组,分别采用单纯双抗治疗(A组,156例)和双抗联合人尿激肽原酶治疗(B组,149例),观察其90d内主要终点事件(新发缺血性卒中)和次要终点事件(短暂性脑缺血发作、心肌梗死或血管性死亡)的发生情况。检测治疗前后凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fib)]变化。结果B组患者主要终点事件发生率低于A组(7.4%vs.16.0%)(P<0.05),两组次要终点事件发生率相仿(3.4%vs.7.4%)(P>0.05)。两组患者治疗前后PT、APTT和Fib均无明显变化(P>0.05)。149例高血压患者在应用人尿激肽原酶治疗期间血压无明显波动(P>0.05)。结论与单纯双抗治疗比较,双抗血小板联合人尿激肽原酶治疗能有效地降低HR-NICE患者新发缺血性卒中事件的发生,且不影响患者凝血功能和血压。
Objective To observe the effect of human pruritus kininogenase and aspirin and clopidogrel antiplatelet on reducing the risk of ischemic stroke within 90 days in patients with high-risk non-disabling ischemic cerebrovascular disease (HR-NICE). Methods 305 patients with HR-NICE were randomly divided into two groups. The patients were treated with anti-double-antibody alone (group A, 156 cases) and double-antibody combined with human serum kininogenase (group B, 149 cases) End point (new ischemic stroke) and secondary end point (transient ischemic attack, myocardial infarction, or vascular death). The changes of coagulation function [prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (Fib)] were measured before and after treatment. Results The incidence of primary end point in group B was lower than that in group A (7.4% vs.16.0%) (P <0.05). The incidence of secondary end points in both groups was similar (3.4% vs.7.4%) (P> 0.05). There was no significant difference in PT, APTT and Fib between the two groups before and after treatment (P> 0.05). There were no significant fluctuations of blood pressure in 149 cases of hypertensive patients during the application of human kallikrein (P> 0.05). Conclusion Compared with simple double-antibody treatment, dual antiplatelet combined with human kallikrein treatment can effectively reduce the occurrence of ischemic stroke in HR-NICE patients without affecting the coagulation function and blood pressure.