王丽　　张颖

[摘要] 目的 觀察阿司匹林、硫酸氢氯吡格雷联合羟乙基淀粉治疗短暂性脑缺血发作（TIA）伴颅内血管狭窄近期疗效及安全性。 方法 收集2018年6月至2020年6月北部战区总医院神经内科确诊98例短暂性脑缺血发作伴颅内血管狭窄患者的临床资料。根据用药情况分为观察组（阿司匹林+硫酸氢氯吡格雷+羟乙基淀粉，n=48）与对照组（阿司匹林+硫酸氢氯吡格雷，n=50）。观察两组7 d内有效率及不良反应。 结果 观察组总有效率高于对照组（93.75% vs. 78.00%），两组比较，差异有统计学意义（χ2=4.961，P=0.026）。观察组不良事件4例，对照组不良事件1例，差异无统计学意义（8.34% vs. 2.00%，χ2=0.932，P=0.334）。 结论 双抗联合羟乙基淀粉对TIA伴有颅内血管狭窄有效，且有良好的安全性。

[关键词] 阿司匹林;硫酸氢氯吡格雷;短暂性脑缺血发作;羟乙基淀粉

[中图分类号] R512.3          [文献标识码] B          [文章编号] 1673-9701（2021）09-0056-04

The short-term efficacy of double antibodies combined with hydroxyethyl starch in the treatment of transient ischemic attack

WANG Li1   ZHANG Ying2

1.Department of Neurology， General Hospital of Northern Theater Command， Shenyang 110016， China; 2.Tieling Health Vocational College， Tieling   112008， China

[Abstract] Objective To observe the short-term efficacy and safety of aspirin， clopidogrel hydrogen sulfate combined with hydroxyethyl starch in the treatment of transient ischemic attack（TIA） complicated with intracranial vascular stenosis. Methods The clinical data of 98 patients diagnosed as TIA complicated with intracranial vascular stenosis admitted to the department of neurology in the General Hospital of Northern Theater Command from June 2018 to June 2020 were collected. According to the medication， they were divided into the observation group（n=48） and the control group（n=50）. The observation group was treated with the combination of aspirin， clopidogrel hydrogen sulfate and hydroxyethyl starch， while the control group was treated with the combination of aspirin and clopidogrel hydrogen sulfate.There was no statistically significant difference in general data between the two groups. The efficacy rate and adverse reactions of the two groups were observed within 7 days. Results The efficacy rate of the observation group was higher than that of the control group （93.75% vs. 78.00%）， with statistically significant difference between the two groups （χ2=4.961， P=0.026）. There were 4 cases of adverse events in the observation group and 1 case of adverse events in the control group，there was no statistically significant differences（8.34% vs. 2.00%， χ2=0.932， P=0.334）. Conclusion Double antibodies combined with hydroxyethyl starch are effective and safe in treating TIA complicated with intracranial vascular stenosis.

[Key words] Aspirin; Clopidogrel bisulfate; Transient ischemic attack; Hydroxyethyl starch

短暂性脑缺血发作（Transient ischemic attack，TIA）是缺血性脑卒中常见类型之一，如不及时治疗约有1/3患者进展为脑梗死。高危TIA 3个月内卒中风险高达20%，而且这种风险大多发生在前7 d内，特别是前2～3 d内[1-2]。目前中外指南均推薦对高危TIA给予双联抗血小板聚集（双抗）治疗[3-4]。研究发现即使给予这类患者双抗治疗，仍有卒中发生。这类患者中包含颅内血管狭窄患者。研究提示合并颅内血管狭窄患者再发卒中风险仍显著高于无颅内血管狭窄患者[5]。寻找治疗这类疾病有效治疗方法一直是研究热点。多个随机对照试验证实中重度狭窄症状性颈动脉狭窄给予颈内动脉内膜剥脱有效。但椎动脉及颅内血管狭窄，药物还是血管内治疗仍存在争议[6-7]。……