Lancet:急性脑缺血的抗血小板治疗

2017-12-21 zhangfan MedSci原创

研究发现,对于新发脑缺血患者,三联抗血小板强化治疗不能降低中风复发风险,反而导致出血事件的频率和严重程度增加。常规临床中不应采用三联抗血小板治疗

与预防急性脑缺血患者复发的标准治疗方案相比,使用三种药物的强化抗血小板治疗可能更为有效。近日研究人员比较了强化抗血小板治疗(阿司匹林、氯吡格雷和双嘧达莫)与基于指南的抗血小板治疗对预防急性脑缺血复发的疗效和安全性。

缺血性卒中或短暂性脑缺血发作48小时内患者参与研究,随机接受30天的强化抗血小板治疗 (75 mg阿司匹林,75 mg氯吡格雷以及200mg双嘧达莫,每天2次)或基于指南的抗血小板治疗(包括氯吡格雷单独或联合阿司匹林或双嘧达莫)。研究的主要终点是90天内任何卒中复发事件。

3096名患者参与研究,其中强化治疗组1556人,标准治疗组1540人。研究发现组间中风复发事件以及严重程度无显著差异 (93 [6%] 例 vs 105 [7%]例; OR 0.90, 95% CI 0.67-1.20, p=0.47),相反强化治疗导致的出血事件频发且更为严重 (OR 2.54, 95% CI 2.05-3.16)。

研究发现,对于新发脑缺血患者,三联抗血小板强化治疗不能降低中风复发风险,反而导致出血事件的频率和严重程度增加。常规临床中不应采用三联抗血小板治疗。

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    2018-04-14 howi
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    2017-12-23 虈亣靌

    如此说来还是一个好事情

    0

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    2017-12-22 oxygen123

    学习了

    0

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    2017-12-21 半夏微凉

    学习了谢谢分享

    0

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    2017-12-21 hhh678

    henhao

    0

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