天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (7): 771-774.doi: 10.11958/20211970

• 应用研究 • 上一篇    下一篇

替格瑞洛对轻型急性脑卒中和TIA患者血小板功能的影响

宫垒，孙海英，蒋显锋，宫平，杨学军   

  1. 1天津医科大学研究生院（邮编300070）；2武警特色医学中心脑系中心疼痛科，3心脏重症医学科；4天津医科大学总医院神经外科
  • 收稿日期:2021-08-27 修回日期:2022-03-29 出版日期:2022-07-15 发布日期:2022-07-15

Effects of ticagrelor on platelet function in patients with minor acute stroke or TIA

GONG Lei, SUN Haiying, JIANG Xianfeng, GONG Ping, YANG Xuejun   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of Pain Treatment, 3 Institute of Cardiovascular Diseases and Heart Center, Chinese People’s Armed Police Force (PAP) Medical Center; 4 Department of Neurosurgery, Tianjin Medical University General Hospital
  • Received:2021-08-27 Revised:2022-03-29 Published:2022-07-15 Online:2022-07-15

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摘要： 目的　探讨Sonoclot法检测替格瑞洛对轻型急性缺血性脑卒中和短暂性脑缺血发作（TIA）患者血小板功能的影响。方法　选取81例轻型急性缺血性脑卒中和TIA患者，随机数字表法分为试验组（39例）和对照组（42例）。前者入院后予以替格瑞洛联合阿司匹林治疗，21 d后改为替格瑞洛片；后者入院后予以氯吡格雷联合阿司匹林治疗，21 d后改为氯吡格雷片。于入院时、治疗7 d和治疗90 d，用Sonoclot法检测2组患者的血小板功能。结果　（1）与对照组相比，试验组在治疗7 d的激活凝血时间（ACT）、达峰时间（TP）值升高，血小板功能（PF）值降低，治疗90 d的ACT值升高（P＜0.05），治疗前后2组间凝血速率（CR）和最大凝血标记值（MCS）差异无统计学意义（P＞0.05）。（2）与入院时相比，2组治疗7 d和90 d的ACT和TP值升高，PF、MCS降低（P＜0.05）。（3）2组治疗后不良事件比较差异无统计学意义（P＞0.05）。结论　与氯吡格雷相比，替格瑞洛能更快地抑制轻型急性缺血性脑卒中或TIA患者血小板功能，且不增加主要出血事件。

关键词: 卒中, 脑缺血发作, 短暂性, 血小板功能试验, 血液凝固试验, 血小板计数, 替格瑞洛, 氯吡格雷, Sonoclot

Abstract: Objective　To explore the effect of ticagrelor on platelet function (PF) in patients with minor acute stroke or transient ischemic attack (TIA). Methods　A total of 81 minor acute stroke or TIA patients were randomly divided into the experimental group (39 patients) and the control group (42 patients). The experimental group was treated with ticagrelor combined with aspirin after admission, and changed to ticagrelor alone after 21 days. The control group was treated with clopidogrel after clopidogrel and aspirin treating for 21 days. On admission, day 7 and day 90 Sonoclot assay was used to measure PF in the two groups. Results　(1) Compared with the control group, the values of activated clotting time (ACT) and time to peak (PT) increased on the 7th day of treatment in the experimental group, and PF decreased. ACT also increased 90 days after treatment (P＜0.05). There were no significant differences in clot rate (CR) and maximal clot signal (MCS) before and after treatment in the two groups (P＞0.05). (2) Compared with those at admission, the values of ACT and TP increased and the PF and MCS decreased in the two groups (P＜0.05). (3) There were no significant differences in the main adverse events between the two groups (P＞0.05). Conclusion　Compared with clopidogrel, ticagrelor can inhibit platelet function more rapidly in patients with minor acute stroke or TIA, but does not increase major bleeding events.

Key words: stroke, ischemic attack, transient, platelet function tests, blood coagulation tests, platelet count, ticagrelor, clopidogrel, Sonoclot