Observation Of Curative Effect Of Maixuekang And Aspirin In Transient Ischemic Attack

Objective To investigate the clinical efficacy and safety of different dosage of Maixuekang combined with aspirin on the treatment of patients with intermediate-or high-risk transient ischemic attack,to provide reference for clinical individualized medicine.Methods 1.Validation of methodology for the measurement of plasma lysophosphatidic acid concentration.2.ABCD2 score is useful for risk stratification of patients with transient ischemic attack.From July 2014 to January 2016,107 patients with ABCD2 scores≥4 were studied,and randomly divided into a low dose group with 52 cases(maixuekang 0.5g tid combined with aspirin 0.1g qd)and a high dose group with 55 cases(maixuekang 1.0g tid combined with aspirin 0.1g qd).Treatment for 3 months.And observing the changes of plasma lysophosphatidic acid(LPA),thrombelastograph(TEG)indicator(reaction time R,Kinetics of Clot Development K,angle α,Maximum Amplitude MA)before treatment and after finishing the periods of treatment for 30 d.Clinincal evaluation and security were analyzed comparatively for 90 days.While 50 cases for health checkup during the same period were selected as normal control group.Measurement data were expressed as mean±standard deviation,t test was used.Chi square test was used in count data.Results1.Established the determination method for plasma LPA concentration.UV spectrophotometry was adopted with a detection wavelength of 636 nm.The regression equation of standard curve was A = 0.0354 C +0.1242(r=0.9997),over the range of 0.75-12μmol(28)L-1,recoveries 98-101%,the intra and inter-day RSD were less than 3.50%.2.Before treatment,the levels of plasma LPA were the highest in the high-risk group,followed by the intermediate-risk group,the lowest in the normal control group,the difference was statistically significant between the 3 groups(P<0.05).After treatment for 30 days,in the intermediate-risk group,there was no significant difference(P>0.05)in plasma LPA concentration between low dose group and high dose group;in high risk group,a significant difference in plasma LPA concentration was observed between low-and high-dose group(P<0.05).3.Before treatment,The levels of R-value、K-value were lowest in the high-risk group,followed by the middle risk group,the highest in the normal control group;The levels of angle、MA were the highest in the high-risk group,followed by the middle risk group,the lowest in the normal control group,the difference was statistically significant between the 3 groups(P<0.05).After 30 days of treatment,in middle risk group,there were no significant difference(P>0.05)of thrombelastograph(R-value、K-value、angle、MA)in low dose group and high dose group;in high risk group,low dose group and high dose group was significant difference(P<0.05)of thrombelastograph(R-value、K-value、angle、MA).4.In middle risk group,the total effective rate of patients with low dose group was 92%,that of patients with high dose group was 96.15%,there was no significant difference between the two groups(P>0.05);adverse reactions rate of low dose group was 4%,that of patients with high dose group was 11.54%,and the adverse reactions rate between the two groups was not statistically significant(P>0.05).In high risk group,the total effective rate of patients with low dose group was 59.26%,that of patients with high dose group was 89.65%,there was significant difference between the two groups(P<0.05);adverse reactions rate of low dose group was 7.41%,that of patients with high dose group was 17.24%,and the adverse reactions rate between the two groups was not statistically significant(P>0.05).Conclusion 1.The established spectrophotometry is accurate,simple,and reproducible,suitable for the concentrations of LPA in human plasma.2.Low dose maixuekang combined with aspirin were effective、security in the treatment of patients with middle risk of transient ischemic attack,and it is worthy for further promotion.3.High dose maixuekang combined with aspirin were effective、security in the treatment of patients with high risk of transient ischemic attack,and it is worthy for further promotion.