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西洛他唑联合阿司匹林和氯吡格雷用于老年脑血管病变患者经皮冠状动脉介入治疗术后的抗血栓作用分析

Antithrombotic effects of cilostazol combined with clopidogrel and aspirin in senile patients with cerebrovas-cular disease after PCI surgery

摘要:

目的 分析西洛他唑联合阿司匹林和氯吡格雷用于老年脑血管病变患者经皮冠状动脉介入治疗(PCI)术后的抗血栓作用.方法 选择行经皮冠状动脉介入治疗(PCI)术的老年脑血管病变患者100例,采用随机数字表法将患者分为对照组和观察组各50例.两组患者均给予控制血压、血脂、血糖及改善循环等常规治疗.对照组采用阿司匹林联合氯吡格雷治疗;观察组在对照组基础上,增服西洛他唑.服药前、服药1周,4周,8周后,应用PL-11型全自动血小板分析仪检测患者血小板的聚集程度.随访2个月,比较患者血小板聚集程度、血小板的体积、治疗的有效率及不良反应发生情况.结果 治疗前,两组血小板聚集率差异无统计学意义(t0=2.782,P>0.05).治疗后两组血小板聚集率明显减少,但观察组用药1周(51.87±9.65)%、用药4周(40.85±10.24)%、用药8周(38.52±9.64)%,明显低于对照组用药1周(69.25±8.41)%、用药4周(62.43±9.22)%、用药8周(58.46±10.18)%的血小板聚集率,差异均有统计意义(t1=5.693,t4=4.846,t8=6.719,均P<0.05).治疗前,两组血小板平均体积差异无统计学意义(t0=2.146,P>0.05);治疗后,两组血小板体积明显降低(t1=1.656,t4=1.438,t8=2.189,P<0.05);观察组与对照组差异无统计学意义(t1=3.716,t4=1.271,t8=2.523,P>0.05).观察组有效率94.00%(47/50)明显高于对照组82.00%(41/50),差异有统计学意义(χ2=4.683,P<0.05).观察组和对照组药物不良反应发生率分别为10.00%(5/50)和8.00%(4/50),差异无统计学意义(χ2=1.947,P=0.136).结论 西洛他唑联合阿司匹林和氯吡格雷用于老年脑血管病变患者PCI术后可明显减少血小板的聚集率,提高临床疗效.

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abstracts:

Objective To analyze the antithrombotic effects of cilostazol combined with aspirin and clopi-dogrel in elderly patients with cerebrovascular disease after PCI .Methods 100 elderly patients with cerebrovascular diseases who treated with coronary artery interventional therapy ( PCI) were randomly divided into the control group and the observation group according to the digital table ,50casess in each group.The two groups were given control of blood pressure ,blood lipids ,blood sugar ,improve circulation and other conventional treatment .The control group was treated with aspirin combined with clopidogrel ,the observation group was treated with cilostazol based on the treatment of control group.Before and after treatment for 1,4 and 8 weeks,the platelet aggregation degree was detected by PL-11 automatic platelet analyzer .During 2 months of follow-up,the degree of platelet aggregation ,the volume of platelets,the efficacy of treatment and the incidence of adverse reactions were compared .Results The platelet aggre-gation rate between the two groups had no statistically significant difference before treatment (t0 =2.782,P>0.05). After treatment,the platelet aggregation rate of the two groups decreased significantly ,but after treatment for 1,4 and 8 weeks,the platelet aggregation rates of the observation group were significantly lower than those of the control group [(51.87 ±9.65)%,(40.85 ±10.24)%,(38.52 ±9.64)%;(69.25 ±8.41)%,(62.43 ±9.22)%,(58.46 ± 10.18)%],the differences were statistically significant (t1 =5.693,t4 =4.846,t8 =6.719,all P<0.05).Before treatment,the mean platelet volume between the two groups had statistically significant difference ( t0 =2.146,P>0.05).After treatment,the platelet volume of the two groups decreased significantly ( t1 =1.656,t4 =1.438,t8 =2.189,all P<0.05).There were no statistically significant differences between the observation group and the control group (t1 =3.716,t4 =1.271,t8 =2.523,all P>0.05).The effective rate of the observation group was 94.00%(47/50),which was significantly higher than that of the control group [82.00%(41/50)],the difference was statis-tically significant (χ2 =4.683,P<0.05).The incidence rates of adverse reactions in the observation group and the control group were 10.00%(5/50) and 8.00%(4/50),respectively,there was no statistically significant difference between the two groups (χ2 =1.947,P=0.136).Conclusion Cilostazol combined with clopidogrel and aspirin in the treatment of elderly patients with cerebrovascular disease after PCI can significantly reduce platelet aggregation rate,improve clinical curative effect ,and has certain clinical value .

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