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目的：观察在合并高纤维蛋白原血症的短暂脑缺血发作(TIA)和急性脑梗死患者中，长期应用阿司匹林和间断使用巴曲酶预 防脑梗死和 TIA 复发的疗效和安全性。方法：将伴有高纤维蛋白原血症的急性脑梗死和(或)TIA 患者依治疗情况分为单纯阿司匹 林治疗组和巴曲酶与阿司匹林联合治疗组。根据随访资料观察患者脑梗死和出血性疾病(包括脑出血、蛛网膜下腔出血和内脏出血) 的发生情况。结果：经过筛选共有93例符合标准的高纤维蛋白原血症患者入组，其中阿司匹林组52例，巴曲酶和阿司匹林联合组41 例。在平均3． 3±2． 5年的随访期内，阿司匹林组有17例(32． 7%)患者发生脑梗死和(或)TIA，巴曲酶和阿司匹林联合组有6例(14． 6%)发生脑梗死和(或)TIA，经卡方检验，巴曲酶和阿司匹林联合组再发脑梗死和(或)TIA 的比例显著低于阿司匹林组(P＜0． 05) 。 阿司匹林组有1例患者发生脑出血，无蛛网膜下腔出血和内脏出血发生，巴曲酶和阿司匹林联合组有1例发生蛛网膜下腔出血，无内 脏出血发生。结论：与单纯使用阿司匹林相比，间断使用巴曲酶使血液纤维蛋白原水平保持在较低水平，可有效减少脑梗死和 TIA 的 发生。与单纯使用阿司匹林组相比，巴曲酶和阿司匹林联合应用不明显增加出血性疾病的发生率。
Objective: To observe the efficacy and safety of long-term aspirin and intermittent batroxobin in preventing cerebral infarction and TIA recurrence in patients with transient ischemic attack (TIA) and acute cerebral infarction complicated by hyper fibrinogen. Methods: Patients with acute cerebral infarction and / or TIA accompanied by hyperfibrinogenemia were divided into simple aspirin group and batroxobin and aspirin group. According to follow-up data were observed in patients with cerebral infarction and hemorrhagic diseases (including cerebral hemorrhage, subarachnoid hemorrhage and visceral bleeding) occurred. RESULTS: A total of 93 patients with hyperfibrinogenemia were screened, of whom 52 were aspirin and 41 were combined batroxobin and aspirin. At an average of 3. 3 ± 2. In the 5-year follow-up period, cerebral infarction occurred in 17 patients (32.7%) in the aspirin group and in 6 (14.6%) patients in the TIA, batroxobin and aspirin groups, and ) TIA, chi-square test, batroxobin and aspirin combined group recurrent cerebral infarction and / or TIA was significantly lower than the proportion of aspirin group (P <0.05). One patient in the aspirin group had cerebral hemorrhage with no subarachnoid hemorrhage and no visceral hemorrhage. One patient in the batroxobin and aspirin group had subarachnoid hemorrhage and no visceral hemorrhage occurred. CONCLUSIONS: Compared with aspirin alone, intermittent use of batroxobin keeps blood fibrinogen levels low, which can effectively reduce the incidence of cerebral infarction and TIA. In combination with aspirin alone, the combination of batroxobin and aspirin did not significantly increase the incidence of hemorrhagic disease.