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目的:评价双联抗血小板药物时间及单一抗血小板药物种类对脑动脉支架术后患者的疗效和不良反应。方法:本实验为回顾性调查研究,共纳入380例病例,根据术后联合使用阿司匹林和氯吡格雷时间长短分为3组:A组(60例)联用1个月,B组(220例)联用3个月,C组(100例)联用4~12个月;根据A、B组病例停用双抗后使用单一抗血小板药物种类不同分为2个亚组:AB1组(132例)服用阿司匹林,AB2组(91例)服用氯吡格雷。通过卡方检验或Fisher精确检验及多因素logistic回归分析比较术后1年内再发脑梗死、脑出血、颅外出血、心肌梗死、死亡等不良事件发生率。结果:术后1年内,A、B、C 3组间再发脑梗死无明显差异(P=0.580);AB组亚组间脑梗死再发率也无统计学差异(P=1.000);A、B、C 3组间及AB组亚组间脑出血、颅外出血、心肌梗死、死亡发生率无统计学差别(P>0.05)。结论:阿司匹林和氯吡格雷联用1个月、3个月、4~12个月以及停用双抗后单用阿司匹林或氯吡格雷具有同等疗效。
OBJECTIVE: To evaluate the efficacy and adverse reactions of dual antiplatelet drugs and single antiplatelet drugs in patients with cerebral arterial stenting. Methods: This study was retrospectively investigated. A total of 380 cases were enrolled in this study. They were divided into 3 groups according to the duration of postoperative combined use of aspirin and clopidogrel: group A (60 cases) for 1 month, group B (220 cases ) For 3 months and group C (100) for 4 to 12 months. According to the different types of single antiplatelet drugs used in group A and group B, they were divided into two subgroups: AB1 group (132 Example) taking aspirin, AB2 group (91 cases) taking clopidogrel. The incidences of recurrent cerebral infarction, intracerebral hemorrhage, extracranial hemorrhage, myocardial infarction and death were compared within one year after operation by chi-square test or Fisher’s exact test and multivariate logistic regression analysis. Results: Within 1 year after operation, there was no significant difference in recurrent cerebral infarction between A, B and C groups (P = 0.580). There was no significant difference in recurrence rate of cerebral infarction among AB group (P = 1.000); A There was no significant difference in the incidence of cerebral hemorrhage, extracranial hemorrhage, myocardial infarction and death between the B, C 3 and AB subgroups (P> 0.05). Conclusion: Aspirin and clopidogrel combined with aspirin or clopidogrel at 1 month, 3 months, 4 ~ 12 months and double-antibody withdrawal have the same effect.