JAMA Neurol:小剂量Rivaroxaban 联合阿司匹林与缺血性脑卒中风险

2019-09-25 MedSci MedSci原创

对于全身性动脉粥样硬化患者,小剂量的rivaroxaban联合阿司匹林会导致心脏栓塞性中风和未确定来源的栓塞性中风风险降低

近日研究人员考察了小剂量rivaroxaban联合阿司匹林与不同缺血性脑卒中亚型的关系。

患有稳定的动脉粥样硬化性血管疾病患者参与研究,参与者每天服用rivaroxaban (2.5毫克一天两次)联合阿司匹林(每天100毫克),rivaroxaban (5毫克,每天两次)或阿司匹林(每天100毫克)。研究的主要终点为随访期间缺血性卒中风险。

共有291例患者发生缺血性脑卒中,女性66例,平均年龄69.4岁,43例(14.8%)曾有非腔隙性脑卒中。研究中,49名患者(16.8%)被诊断为心房颤动。应用TOAST标准,59例(20.3%)为心脏栓塞,54例(18.6%)继发50%以上同侧颈内动脉狭窄,42例(14.4%)符合来源不明栓塞性脑卒中标准,21例(7.2%)继发于小血管病变。与单纯阿司匹林组比较,联合治疗组心脏栓塞性卒中风险 (危险比[HR]:0.40)和未确定来源的栓塞性脑卒中明显减少(HR:0.30),小血管病变继发脑卒中呈现出减少的趋势(HR:0.36),但差异较少。颈动脉狭窄>50%的脑卒中,发生率两组间比较无显着性差异(HR:0.85)。rivaroxaban 5mg,每日2次,与阿司匹林相比有降低心栓塞性中风的趋势(HR:0.57),但与其他脑卒中亚型风险降低无关。

对于全身性动脉粥样硬化患者,小剂量的rivaroxaban联合阿司匹林会导致心脏栓塞性中风和未确定来源的栓塞性中风风险降低。

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    2019-10-19 yinhl1978
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    2019-12-08 pyaili
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    2019-09-25 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2019-09-25 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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