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沙格雷酯联合阿司匹林在中国接受颈动脉内膜切除术患者中的疗效:一项单中心回顾性研究。

Effects of Sarpogrelate Combined with Aspirin in Patients Undergoing Carotid Endarterectomy in China: A Single-Center Retrospective Study.

作者信息

Guo Jianming, Gu Yongquan, Guo Lianrui, Yu Hengxi, Qi Lixing, Tong Zhu, Zhang Jian, Wang Zhonghao

机构信息

Department of Vascular Surgery, Xuanwu Hospital, Institute of Vascular Surgery, Capital Medical University, Beijing, China.

Department of Vascular Surgery, Xuanwu Hospital, Institute of Vascular Surgery, Capital Medical University, Beijing, China.

出版信息

Ann Vasc Surg. 2016 Aug;35:183-8. doi: 10.1016/j.avsg.2016.01.032. Epub 2016 May 27.

Abstract

BACKGROUND

Patients undergoing carotid artery stenosis who are prescribed aspirin, clopidogrel, or sarpogrelate as treatment options to inhibit platelet aggregation continues to increase. The purpose of this study was to compare the efficacy and safety of clopidogrel combined with aspirin (CA) versus sarpogrelate combined with aspirin (SA) treatment in carotid endarterectomy (CEA) patients.

METHODS

This retrospective study included 197 CEA patients (mean age 61.4 years, mean follow-up time 42.5 months), who were divided into a CA group (Group A: 65 male and 44 female patients) and an SA group (Group B: 58 male and 30 female patients). Preoperative demographic and clinical characteristics and postoperative results were compared between the 2 groups and statistically analyzed.

RESULTS

Preoperative demographic and clinical characteristics, transfusions, hospital stay, occurrence of transient ischemic attack, stroke, myocardial infarction, restenosis, general or life-threatening bleeding, and 30-day mortality showed no significant differences between the 2 CEA patient groups. However, the mean operative blood loss (P = 0.023) and the operative time (P = 0.040) were significantly higher in Group A compared with Group B. A highly significant incidence of neck hematoma (P = 0.024) was observed in patients of Group A.

CONCLUSIONS

In this study on CEA patients, antiplatelet treatment with CA resulted in a significant risk of developing neck hematoma, increased operative blood loss, and operative time compared with SA treatment. Long-term prospective studies with larger study populations are needed to further confirm the utility of SA treatment for CEA patients.

摘要

背景

接受颈动脉狭窄治疗且被处方使用阿司匹林、氯吡格雷或沙格雷酯作为抑制血小板聚集治疗方案的患者持续增加。本研究的目的是比较氯吡格雷联合阿司匹林(CA)与沙格雷酯联合阿司匹林(SA)治疗在颈动脉内膜切除术(CEA)患者中的疗效和安全性。

方法

这项回顾性研究纳入了197例CEA患者(平均年龄61.4岁,平均随访时间42.5个月),这些患者被分为CA组(A组:65例男性和44例女性患者)和SA组(B组:58例男性和30例女性患者)。比较两组患者术前的人口统计学和临床特征以及术后结果,并进行统计学分析。

结果

两组CEA患者术前的人口统计学和临床特征、输血情况、住院时间、短暂性脑缺血发作、中风、心肌梗死、再狭窄、一般或危及生命的出血以及30天死亡率均无显著差异。然而,A组的平均手术失血量(P = 0.023)和手术时间(P = 0.040)显著高于B组。A组患者颈部血肿的发生率极高(P = 0.024)。

结论

在这项针对CEA患者的研究中,与SA治疗相比,CA抗血小板治疗导致颈部血肿形成、手术失血量增加和手术时间延长的风险显著增加。需要更大规模研究人群的长期前瞻性研究来进一步证实SA治疗对CEA患者的效用。

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