目的 探討西洛他唑片聯(lián)合阿司匹林腸溶片及硫酸氫氯吡格雷片對(duì)頸動(dòng)脈狹窄患者神經(jīng)介入后血栓影響及安全性。方法 選擇2015年1月-2017年12月楊凌示范區(qū)醫(yī)院收治的60例行神經(jīng)介入治療的頸動(dòng)脈狹窄患者，根據(jù)隨機(jī)數(shù)字表法，分為觀察組及對(duì)照組。兩組患者采用遠(yuǎn)端保護(hù)裝置，根據(jù)病變血管的特征，選擇合適的支架種類進(jìn)行前后擴(kuò)張。對(duì)照組患者口服阿司匹林腸溶片300 mg/次，1次/d，硫酸氫氯吡格雷片75 mg/次，1次/d；觀察組在對(duì)照組基礎(chǔ)上口服西洛他唑片200 mg/d，2次/d。兩組療程均為術(shù)前1周至術(shù)后6個(gè)月。觀察兩組患者治療前后的血小板聚集率、血流動(dòng)力學(xué)及血脂指標(biāo)，觀察兩組治療過程中的不良反應(yīng)、缺血事件及缺血病灶例數(shù)。結(jié)果 治療后，兩組的血小板聚集率、紅細(xì)胞壓積、纖維蛋白原均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后觀察組均明顯低于對(duì)照組，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）均明顯降低，高密度脂蛋白膽固醇（HDL-C）明顯上升，同組治療前后比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組明顯優(yōu)于對(duì)照組，組間差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者的不良反應(yīng)無統(tǒng)計(jì)學(xué)意義；觀察組的缺血事件及缺血病灶發(fā)生率明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 西洛他唑片聯(lián)合阿司匹林腸溶片及硫酸氫氯吡格雷片三聯(lián)療法對(duì)頸動(dòng)脈狹窄患者神經(jīng)介入術(shù)后抗血栓作用較好，且不增加不良反應(yīng)發(fā)生率。

Objective To investigate the effect and safety of Cilostazol Tablets combined with Aspirin Enteric-coated Tablets and Clopidogrel Hydrogen Sulphate Tablets on thrombosis after neurointervention in patients with carotid artery stenosis. Methods 60 cases with carotid artery stenosis after neurointervention in Yangling Demonstration Zone Hospital were chosen, who were divided into the observation group and control group according to random number table method. Patients in two groups were treated with distal protection device. According to the characteristics of the lesion vessels, appropriate stent types were selected for anterior and posterior dilatation. Patients in the control group were po administered with Aspirin Enteric-coated Tablets, 300 mg/time, once daily, and Clopidogrel Hydrogen Sulphate Tablets 75 mg/time, once daily. Patients in the observation group po administered with Cilostazol Tablets on the basis of control group, 200 mg/d, twice daily. Both groups were treated from 1 week before operation to 6 months after operation. The platelet aggregation rate, hemodynamics and blood lipids indexes in two groups before and after treatment, and the adverse reactions, ischemic events and ischemic lesions number were compared. Results After treatment, the platelet aggregation rate, hematocrit and fibrinogen in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observation group was significantly lower than the control group, with significant difference between two groups (P<0.05). After treatment, TC, TG, LDL-C in two groups were significantly decreased, HDL-C was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observation group was significantly better than the control group, with significant difference between two groups (P<0.05). There was no significant difference in adverse reactions between the two groups. The incidence of ischemic events and ischemic lesions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Cilostazol Tablets combined with Aspirin Enteric-coated Tablets and Clopidogrel Hydrogen Sulphate Tablets triple antiplatelet had better antithrombotic effects on thrombosis after neurointervention in patients with carotid artery stenosis, and which could not increase the adverse reactions incidence.