中国临床药理学杂志

替格瑞洛联合阿司匹林用于首发动脉粥样硬化性急性脑梗死青年患者的临床研究

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王宁宁 ^a , 段红芬 ^a , 李倩 ^a , 王立敏 ^a , 曲明卫 ^a , 杨潮萍 ^a , 张欢 ^b

中国临床药理学杂志 | 临床与基础桥接研究 2026,42(4): 464-471

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中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (4) : 464 -471

替格瑞洛联合阿司匹林用于首发动脉粥样硬化性急性脑梗死青年患者的临床研究

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王宁宁^a, 段红芬^a, 李倩^a, 王立敏^a, 曲明卫^a, 杨潮萍^a, 张欢^b

作者信息

^a.沧州市中心医院眩晕一科，河北沧州 061000

^b.沧州市中心医院药学部，河北沧州 061000

通讯作者:

王宁宁 MP: 13313377511 E-mail: 13313377511@163.com

作者简介:

王宁宁（1989-），女，主治医师，主要从事脑血管病及眩晕方面的工作和研究

Clinical trial of ticagrelor in young patients with first-onset atherosclerotic acute cerebral infarction

Ning-ning WANG^a, Hong-fen DUAN^a, Qian LI^a, Li-min WANG^a, Ming-wei QU^a, Chao-ping YANG^a, Huan ZHANG^b

Affiliations

^a.Department of Vertigo, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China

^b.Pharmacy Department, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China

出版时间: 2026-02-28 doi: 10.13699/j.cnki.1001-6821.2026.04.003

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摘要

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目的

研究替格瑞洛片联合阿司匹林肠溶片用于首发动脉粥样硬化性急性脑梗死青年患者的临床疗效，并进行安全性评价。

方法

将首发动脉粥样硬化性急性脑梗死青年患者根据不同的治疗方案，分为试验组和对照组，试验组给予阿司匹林肠溶片联合替格瑞洛片治疗，首次剂量：阿司匹林肠溶片100 mg·d^-1，替格瑞洛片180 mg·d^-1；维持剂量：阿司匹林肠溶片100 mg·d^-1，替格瑞洛片90 mg·d^-1；对照组给予阿司匹林肠溶片联合氯吡格雷片治疗，首次剂量：阿司匹林肠溶片100 mg·d^-1，氯吡格雷片300 mg·d^-1；维持剂量：阿司匹林肠溶片100 mg·d^-1，氯吡格雷片75 mg·d^-1；2组疗程均为3个月。治疗3个月后，比较2组的疗效、美国国立卫生院卒中量表（NIHSS）评分、脑血流动力学、Barthel指数、血小板聚集率、不良心血管事件并进行安全性评价。

结果

共入组103例患者，试验组53例，对照组50例。治疗3个月后，试验组与对照组的总有效率比分别为92.45%（49例/53例）和88.00%（44例/50例），2组比较，在统计学上差异无统计学意义（P>0.05）。试验组和对照组治疗3个月后大脑中动脉（MCA）的平均血流速度（Vmean）分别为（56.73±11.05）和（50.50±10.33）cm·s^-1，大脑前动脉（ACA）的Vmean分别为（45.92±9.83）和（41.28±8.22）cm·s^-1，大脑后动脉（PCA）的Vmean分别为（50.11±10.33）和（45.59±9.12）cm·s^-1，椎动脉（VA）的Vmean分别为（52.67±10.49）和（47.81±9.63）cm·s^-1，基底动脉（BA）的Vmean分别为（53.75±10.28）和（48.29±9.60）cm·s^-1，血小板聚集率分别为（22.71±7.33）%和（26.47±7.35）%，上述指标，2组间比较，在统计学上差异均有统计学意义（P<0.05，P<0.01）。治疗3个月后试验组和对照组NIHSS评分分别为（1.23±0.47）和（1.38±0.49）分，Barthel指数分别为（92.17±5.17）和（90.08±6.37）分，试验组上述指标与对照组比较，在统计学上差异均无统计学意义（均P>0.05）。试验组与对照组的不良心血管事件发生率分别为0%和8.00%（4例/50例），在统计学差异上无统计学意义（P>0.05）。试验组药物不良反应包括消化道反应、出血倾向、高尿酸血症、心动过缓，总不良反应发生率为13.21%（7例/53例），对照组药物不良反应包括消化道反应、出血倾向，总药物不良反应发生率为10.00%（5例/50例），在统计学上差异无统计学意义（P>0.05）。

结论

首发动脉粥样硬化性急性脑梗死青年患者应用替格瑞洛片联合阿司匹林肠溶片治疗可明显改善脑血流动力学，更具优势。

关键词

替格瑞洛片 / 氯吡格雷片 / 阿司匹林肠溶片 / 急性脑梗死 / 动脉粥样硬化 / 脑血流动力学

Abstract

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Objective

To analyze the therapeutic effects and safety of ticagrelor tablets combined with aspirin enteric-coated tablets on young patients with first-onset atherosclerotic acute cerebral infarction.

Methods

According to different treatment plans, the patients with first-onset atherosclerotic acute cerebral infarction were divided into the treatment group and the control group. The treatment group was treated with aspirin enteric-coated tablets combined with ticagrelor tablets (initial dose: aspirin enteric-coated tablets 100 mg·d^-1 and ticagrelor tablets 180 mg·d^-1, maintenance dose: aspirin enteric-coated tablets 100 mg·d^-1 and ticagrelor tablets 90 mg·d^-1). The control group was treated with aspirin enteric-coated tablets combined with clopidogrel tablets (initial dose: aspirin enteric-coated tablets 100 mg·d^-1 and clopidogrel tablets 300 mg·d^-1, maintenance dose: aspirin enteric-coated tablets 100 mg·d^-1 and clopidogrel tablets 75 mg·d^-1). The courses of treatment for both groups were 3 months. After 3 months of treatment, the efficacy, National Institutes of Health stroke scale (NIHSS) scores, cerebral hemodynamics, Barthel index, platelet aggregation rate, modified Rankin scale (mRS) scores, adverse cardiovascular events, and adverse reactions were observed.

Results

A total of 103 patients were enrolled, with 53 cases in treatment group and 50 patients in control group. After 3 months of treatment, the total effective rates in the treatment group and the control group were 92.45% (49 cases/53 cases) and 88.00% (44 cases/50 cases), with no statistically significant difference between groups (P>0.05). After 3 months of treatment, the mean blood flow velocities (Vmean) of the middle cerebral artery (MCA) in the treatment group and the control group were (56.73±11.05) and (50.50±10.33) cm·s^-1, respectively; the Vmean of the anterior cerebral artery (ACA) were (45.92±9.83) and (41.28±8.22) cm·s^-1, respectively; the Vmean of the posterior cerebral artery (PCA) were (50.11±10.33) and (45.59±9.12) cm·s^-1, respectively; the Vmean of the vertebral artery (VA) were (52.67±10.49) and (47.81±9.63) cm·s^-1, respectively; the Vmean of basilar artery (BA) were (53.75±10.28) and (48.29±9.60) cm·s^-1, respectively; the platelet aggregation rates were (22.71±7.33)% and (26.47±7.35)%, respectively; the above indexes in the treatment group were significantly different from those in the control group (P<0.05, P<0.01). After 3 months of treatment, the NIHSS scores of the treatment group and the control group were (1.23±0.47) and (1.38±0.49) points, respectively, and the Barthel indexes were (92.17±5.17) and (90.08±6.37) points, respectively. There was no statistically significant difference in the NIHSS score and Barthel index between the treatment group and the control group (all P>0.05). The incidences of adverse cardiovascular events in treatment group and control group were 0% and 8.00% (4 cases/50 cases), respectively, with no statistically significant difference (P>0.05). Adverse drug reactions in the treatment group included gastrointestinal reactions, bleeding tendency, hyperuricemia, and bradycardia, with a total incidence of 13.21% (7 cases/53 cases); adverse drug reactions in the control group included gastrointestinal reactions and bleeding tendency, with a total incidence of 10.00% (5 cases/50 cases); there was no statistically significant difference between groups (P>0.05).

Conclusion

Applying ticagrelor tablets to treat young patients with first-onset atherosclerotic acute cerebral infarction can significantly improve cerebral hemodynamics, with more advantages.

Key words

ticagrelor tablet / clopidogrel tablet / aspirin enteric-coated tablet / acute cerebral infarction / atherosclerosis / cerebral hemodynamics

引用本文

王宁宁, 段红芬, 李倩, 王立敏, 曲明卫, 杨潮萍, 张欢. 替格瑞洛联合阿司匹林用于首发动脉粥样硬化性急性脑梗死青年患者的临床研究. 中国临床药理学杂志, 2026 , 42 (4) : 464 -471 . DOI: 10.13699/j.cnki.1001-6821.2026.04.003

Ning-ning WANG, Hong-fen DUAN, Qian LI, Li-min WANG, Ming-wei QU, Chao-ping YANG, Huan ZHANG. Clinical trial of ticagrelor in young patients with first-onset atherosclerotic acute cerebral infarction[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (4) : 464 -471 . DOI: 10.13699/j.cnki.1001-6821.2026.04.003

基金

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沧州市重点研发计划自筹资金资助项目(23244102093)

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2026年第42卷第4期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2026.04.003

接收时间：2025-09-22
首发时间：2026-08-06
出版时间：2026-02-28

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收稿日期：2025-09-22

基金

沧州市重点研发计划自筹资金资助项目(23244102093)

作者信息

^a.沧州市中心医院眩晕一科，河北沧州 061000

^b.沧州市中心医院药学部，河北沧州 061000

通讯作者:

王宁宁 MP: 13313377511 E-mail: 13313377511@163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.04.003

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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