阿司匹林在不同年龄段脑梗死患者中二级预防的研究

目的:观察阿司匹林在不同年龄段脑梗死患者中二级预防的效果。方法:将300例脑梗死患者分为暴露组(服用阿司匹林)与非暴露组(不服用阿司匹林和任何抗血小板药物),各50例,回顾性分析不同年龄段(41~50岁,51~60岁,61~70岁,71~80岁,81~90岁)脑梗死的复发、脑出血、蛛网膜下腔出血或者消化道出血的发生率。结果:暴露组脑梗死的各个年龄段复发率明显低于非暴露组(P0.05),上消化道出血则明显高于非暴露组(P0.05);暴露组和非暴露组脑出血率与蛛网膜下腔出血率在41~50岁和51~60岁阶段,没有明显差异(P0.05),在61~70岁,71~80岁和81~90岁3个年龄段,暴露组显著低于非暴露组(P0.05)。需治疗例数随着年龄增加逐渐增多,71~90岁时增加,具有统计学意义(P0.05);在61~70岁年龄段相对危险度最高,81~90岁年龄段危险度最大。结论:阿司匹林在不同年龄段脑梗死患者中二级预防效果存在差别,41~60岁之间应用阿司匹林进行二级预防获益最大,风险最小。

Aspirin in patients with cerebral infarction at different ages in secondary prevention

Objective: To investigate aspirin in patients with cerebral infarction at different ages in secondary prevention effect. Methods: The cerebral infarction patients were divided into exposure group (aspirin) and non-exposed group (not taking any aspirin or antiplatelet drugs), a retrospective analysis of different age groups (41-50 years, 51-60 years, 61-70 years , 71-80 years, 81-90 years) recurrence of cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage or gastrointestinal bleeding incidence situation. Results: The recurrence of cerebral infarction of all ages exposed group was significantly lower than non-exposed group (P <0.05), and upper gastrointestinal bleeding was significantly higher than the non-exposed group (P <0.05); in the 61 - 90 age group exposed brain hemorrhage and subarachnoid hemorrhage increasing trend was significantly lower than non-exposed group (P <0.05). 41-80 age group, the rate of each exposure group cerebral hemorrhage and subarachnoid hemorrhage rate did not change significantly (P> 0.05), and between 71-90 years of age, each exposure group cerebral hemorrhage and subarachnoid hemorrhage rate was significantly increased (P <0.05). Significantly increased (P <0.05) takes several Cases occur in 71-90 age group; relative risk for the highest degree of 61-70 years of age, 81-90 years of age attributable risk maximum. Conclusion: Aspirin differ in different age groups in patients with cerebral infarction secondary prevention effect, aspirin for secondary prevention among 41-60-year-old to benefit the most, the least risk.