替格瑞洛联合阿司匹林用于首发动脉粥样硬化性急性脑梗死青年患者的临床研究OA

Objective To analyze the therapeutic effects and safety of ticagrelor tablets combined with aspirin enteric-coated tablets on young patients with first-onset atherosclerotic acute cerebral infarction.Methods According to different treatment plans,the patients with first-onset atherosclerotic acute cerebral infarction were divided into the treatment group and the control group.The treatment group was treated with aspirin enteric-coated tablets combined with ticagrelor tablets(initial dose:aspirin enteric-coated tablets 100 mg·d-1 and ticagrelor tablets 180 mg·d-1,maintenance dose:aspirin enteric-coated tablets 100 mg·d-1 and ticagrelor tablets 90 mg·d-1).The control group was treated with aspirin enteric-coated tablets combined with clopidogrel tablets(initial dose:aspirin enteric-coated tablets 100 mg·d-1 and clopidogrel tablets 300 mg·d-1,maintenance dose:aspirin enteric-coated tablets 100 mg·d-1 and clopidogrel tablets 75 mg·d-1).The courses of treatment for both groups were 3 months.After 3 months of treatment,the efficacy,National Institutes of Health stroke scale(NIHSS)scores,cerebral hemodynamics,Barthel index,platelet aggregation rate,modified Rankin scale(mRS)scores,adverse cardiovascular events,and adverse reactions were observed.Results A total of 103 patients were enrolled,with 53 cases in treatment group and 50 patients in control group.After 3 months of treatment,the total effective rates in the treatment group and the control group were 92.45％(49 cases/53 cases)and 88.00％(44 cases/50 cases),with no statistically significant difference between groups(P＞0.05).After 3 months of treatment,the mean blood flow velocities(Vmean)of the middle cerebral artery(MCA)in the treatment group and the control group were(56.73±11.05)and(50.50±10.33)cm·s-1,respectively;the Vmean of the anterior cerebral artery(ACA)were(45.92±9.83)and(41.28±8.22)cm·s-1,respectively;the Vmean of the posterior cerebral artery(PCA)were(50.11±10.33)and(45.59±9.12)cm·s-1,respectively;the Vmean of the vertebral artery(VA)were(52.67±10.49)and(47.81±9.63)cm·s-1,respectively;the Vmean of basilar artery(BA)were(53.75±10.28)and(48.29±9.60)cm·s-1,respectively;the platelet aggregation rates were(22.71±7.33)％and(26.47±7.35)％,respectively;the above indexes in the treatment group were significantly different from those in the control group(P＜0.05,P＜0.01).After 3 months of treatment,the NIHSS scores of the treatment group and the control group were(1.23±0.47)and(1.38±0.49)points,respectively,and the Barthel indexes were(92.17±5.17)and(90.08±6.37)points,respectively.There was no statistically significant difference in the NIHSS score and Barthel index between the treatment group and the control group(all P＞0.05).The incidences of adverse cardiovascular events in treatment group and control group were 0％and 8.00％(4 cases/50 cases),respectively,with no statistically significant difference(P＞0.05).Adverse drug reactions in the treatment group included gastrointestinal reactions,bleeding tendency,hyperuricemia,and bradycardia,with a total incidence of 13.21％(7 cases/53 cases);adverse drug reactions in the control group included gastrointestinal reactions and bleeding tendency,with a total incidence of 10.00％(5 cases/50 cases);there was no statistically significant difference between groups(P＞0.05).Conclusion Applying ticagrelor tablets to treat young patients with first-onset atherosclerotic acute cerebral infarction can significantly improve cerebral hemodynamics,with more advantages.