张耀元　武雪亮　邹玉安

[摘要] 目的 观察沙格雷酯联合氯吡格雷用于颈动脉支架植入术（CAS）后的临床效果和安全性。 方法 回顾性分析河北北方学院附属第一医院神经内科、血管外科2012年1月～2015年1月收治行CAS治疗的55例颈动脉狭窄患者完整的临床随访资料。根据治疗方法不同，将患者分为沙格雷酯联合氯吡格雷组（观察组，28例）和阿司匹林联合氯吡格雷组（对照组，27例），比较术后患者新发脑卒中、再狭窄和出血事件的发生率和死亡率。 结果 两组再发脑卒中、再狭窄发生情况比较，差异无统计学意义（P > 0.05）；观察组出血事件发生率低于对照组（P < 0.05）；两组均无死亡病例（P > 0.05）。 结论 对于CAS术后患者，沙格雷酯联合氯吡格雷较阿司匹林联合氯吡格雷治疗在新发脑卒中、再狭窄发生率和死亡率方面无明显差异，但在出血方面沙格雷酯更安全、有效。

[关键词] 沙格雷酯；氯吡格雷；颈动脉支架植入术后；应用研究

[中图分类号] R543.4 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0047-04

Application effect of Sarpogrelate combined with Clopidogrel in patients after carotid artery stenting

ZHANG Yaoyuan1 WU Xueliang2 ZOU Yu′an1

1.Department of Neurology， the First Affiliated Hospital of Hebei North University， Hebei Province， Zhangjiakou 075000， China； 2.Department of Vascular Surgery， the First Affiliated Hospital of Hebei North University， Hebei Province， Zhangjiakou 075000， China

[Abstract] Objective To discuss the clinical effectiveness and safety of Sarpogrelate combined with Clopidogrel in carotid artery stenting （CAS）. Methods The clinical follow-up data of 55 cases with carotid artery stenosis treated by carotid artery stenting were retrospectively collected from January 2012 to January 2015 in the Department of Neurology and Vsculr Surgery in the First Affiliated Hospital of Hebei North University. According to treatment method， all patients were divided into Sarpogrelate combined with Clopidogrel group （observation group， 28 cases） and Aspirin combined with Clopidogrel （control group， 27 cases）. Postoperative new stroke， restenosis， bleeding and mortality were compared between two groups. Results There was no significant difference with new stroke and restenosis between two groups （P > 0.05）. The incidence of bleeding events in the observation group was lower than that in the control group （P < 0.05）. There was no death between two groups （P > 0.05）. Conclusion Sarpogrelate combined with Clopidogrel compared with Aspirin combined with Clopidogrel for antiplatelet therapy after CAS has no differences in new stroke and restenosis. Sarpogrelate is more safer and effective than Aspirin.

[Key words] Sarpogrelate； Clopidogrel； Carotid artery stenting； Application research

頸动脉狭窄是缺血性脑血管病最常见的病因之一，其机制为内膜增生或斑块脱落引起远端动脉狭窄或栓塞，造成血流低灌注，导致缺血性脑卒中发生。依据颈动脉狭窄的程度和症状，有传统的外科手术治疗即内膜剥脱术（CEA）和介入治疗即颈动脉支架植入术（CAS）[1-2]。近年来，随着材料科学的不断发展改进，CAS作为替代外科手术的选择，成为预防治疗脑卒中的核心治疗方式，已广泛应用于临床，取得了良好效果[3-4]。但关于CAS术后抗血小板药物的应用尚无明确共识。阿……