张犇

【摘要】目的：探究替格瑞洛片聯合阿司匹林治疗颅内大动脉狭窄合并脑小血管病的临床效果。方法：选取本院2017年8月至2018年8月本院收治的160例大血管狭窄合并脑小血管疾病患者作为研究对象，采用随机数字表法分为对照组和实验组， 对照组患者采用阿司匹林治疗， 实验组患者采用替格瑞洛片联合阿司匹林治疗，评估两组患者改良Rankin评分量表（mRS）、日常生活能力量表（ADL）、美国国立卫生院NIHSS评分、新发血管事件发生情况。结果：患者接受治疗后1个月、6个月、12个月后，实验组患者mRS评分显著低于对照组，且随着治疗后时间延长，两组患者mRS评分逐渐降低;患者接受治疗后1个月、6个月、12个月后，实验组患者ADL评分显著高于对照组，且随着治疗后时间延长，两组患者ADL评分逐渐升高;患者接受治疗后1个月、6个月、12个月后，实验组患者NIHSS评分显著低于对照组，且随着治疗后时间延长，两组患者NIHSS评分逐渐降低;对照组患者发生TIA、再发脑梗死、脑出血例数分别为7（8.75%），5（6.25%），4（5%）; 实验组患者发生TIA、再发脑梗死、脑出血例数分别为4（5%），2（2.5%），1（1.25%）。实验组患者1年内新发血管事件发生率明显低于对照组。结论：在颅内大动脉狭窄合并小血管病患者接受阿司匹林和替格瑞洛联用方案，可有效促进患者神经功能的恢复，提高患者生活质量，降低患者新发血管事件发生率。

【关键词】阿司匹林;替格瑞洛;颅内大动脉狭窄合并小血管病;临床效果

【中图分类号】R743     【文献标识码】A     【文章编号】1004-7484（2019）10-0043-02

Clinical study of ticagrelor tablets combined with aspirin tablets in the treatment of intracranial aortic stenosis with small vessel disease

【Abstract】 Objective： To investigate the clinical effects of ticagrelor combined with aspirin in the treatment of intracranial aortic stenosis with cerebral small vessel disease. Methods： A total of 160 patients with macrovascular stenosis and cerebral small vessel disease admitted to our hospital from August 2017 to August 2018 were enrolled in this study. The patients were divided into the control group and the experimental group by random number table method. Aspirin treatment， patients in the experimental group were treated with ticagrelor tablets combined with aspirin， and the modified Rankin Rating Scale （mRS）， Daily Living Capacity Scale （ADL）， National Institutes of Health NIHSS score， and new vascular events were evaluated in both groups. Happening. Results：After 1 month， 6 months， and 12 months after treatment， the mRS scores of the experimental group were significantly lower than those of the control group， and with the prolonged time after treatment， the mRS scores of the two groups gradually decreased; after the patients received treatment After 1 month， 6 months， and 12 months， the ADL score of the experimental group was significantly higher than that of the control group， and with the prolongation of treatment， the ADL scores of the two groups gradually increased; 1 month and 6 after the patients received treatment. After 1 month and 12 months， the NIHSS score of the experimental group was significantly lower than that of the control group， and with the prolongation of treatment， the NIHSS scores of the two groups gradually decreased. The number of TIA， recurrent cerebral infarction， and cerebral hemorrhage occurred in the control group. They were 7 （8.75%）， 5 （6.25%）， and 4 （5%）. The number of TIA， recurrent cerebral infarction， and cerebral hemorrhage in the experimental group were 4 （5%）， 2 （2.5%）， respectively. （1.25%）. The incidence of new vascular events in the experimental group was significantly lower than that in the control group within 1 year. Conclusion： The combination of aspirin and ticagrelor in patients with intracranial aortic stenosis and small vessel disease can effectively promote the recovery of neurological function， improve the quality of life of patients， and reduce the incidence of new vascular events.

【Key words】aspirin; ticagrelor; intracranial aortic stenosis with small vessel disease; clinical effect

脑小血管疾病（cerebral small vessel disease，CSVD）是一种脑组织在受到机械性损伤或病理感染等多因素作用下所致脑部微循环障碍，能够导致临床、影像学、病理表现和认知发生改变[1， 2]。……