目的：观察西洛他唑对阿司匹林抵抗的短暂性脑缺血发作（TIA）的抗血小板作用。方法选取2010年9月-2012年9月在本院神经内科住院的313例TIA患者，采用自身前后对照研究方法。 TIA患者在服用阿司匹林7 d后测量血小板聚集率和评估临床症状改善情况，据此诊断是否存在阿司匹林抵抗（ AR）。之后停用阿司匹林，改服西洛他唑治疗14d，然后再次测量血小板聚集率和评估临床症状改善情况。结果313例TIA患者中，有35例（11.2％）存在AR。 AR患者经阿司匹林治疗7 d后，二磷酸腺苷（ADP）、花生四烯酸（AA）诱导的血小板聚集率分别为（78.2±12.2）％和（27.5±7.8）％，与治疗前的（81.5±10.1）％和（30.6±9.8）％比较无差异（P＞0.05）；停用阿司匹林，改用西洛他唑治疗14 d后， ADP、 AA诱导的血小板聚集率分别为（41.4±9.8）％和（17.3±5.8）％，均低于治疗前（ P＜0.05）。西洛他唑治疗14 d后，患者临床症状完全改善34例（97.1％）。西洛他唑治疗中均无明显不良反应发生。结论西洛他唑对AR的TIA患者确有抗血小板作用，可以用于治疗AR的TIA。%ObjectiveToassesstheinfluenceofcilostazolontheanti-plateletfunctioninpatientswithtransientis-chemic attack (TIA) with aspirin resistance ( AR) .Methods An open self -controlled clinical study was conducted among 313 TIA patients admitted to the department of neurology from September 2010 to September 2012.The platelet aggregation rate and clinical improvement were tested among the TIA patients 7 days after taking aspirin in order to judge whether there was AR.The aspirin was then changed into cilostazol for 14 days, and the platelet aggregation rate and clinical improvement were test-ed again.Results Among the 313 TIA patients, 35 (11.2%) had AR.After 7 days treatment by aspirin , the platelet aggrega-tion rate induced by ADP and AA in the AR patients was (78.2 ±12.2)%and (27.5 ±7.8)%respectively, showing no statis-tically significant difference compared with those before the treatment , which was (81.5 ±10.1)%and (30.6 ±9.8)%respec-tively ( P>0.05 ) .After 14 days treatment by cilostazol , the platelet aggregation rate induced by ADP and AA was ( 41.4 ±9.8)%and (17.3 ±5.8)% respectively, lower than those before the treatment (P <0.05) .Meanwhile, 34 patients (97.1%) showed complete clinical improvement , and no obvious adverse reaction was found during the treatment by cilosta-zol.Conclusion Cilostazol has anti -platelet function in TIA patients with AR , and can be used to treat TIA with AR .
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