阿司匹林预防缺血性脑血管病临床研究

目的　研究阿司匹林 (ASA)预防缺血性卒中的疗效和最佳剂量。方法　 10 0 0例缺血性脑血管病人随机分为ASAⅠ组 (5 0mg/d ,3 0 2例 )、ASAⅡ组 (3 0 0mg/d ,2 11例 )、ASAⅢ组 (10 0 0mg/d ,2 3 2例 )和对照组 (2 5 5例 ) ,随访2 4～ 60 (平均 3 0 .5 )个月。结果　ASA组卒中发生率 (平均 10 .9% )明显低于对照组 (19.6% ) (P <0 .0 1) ;ASA组病死率(平均 2 .5 % )低于对照组 (7.9% ) (P <0 .0 1) ;ASA组卒中与死亡危险性较对照组降低 3 9% [相对危险性 (RR )为 0 .62 ,95 %可信区间为 0 .45 0～ 0 .86] ;ASA组不良反应发生率为 3 4.8%。结论　ASA能降低缺血性卒中和死亡发生率 ,且最佳剂量为 5 0mg/d。

Aspirin in the prevention of ischaemic cerebrovascular disease

Objective To study the curative effect of aspirin ischaemic cerebrovscular disease and the best dose.Methods 1000 pateints with ischaemic cerebrovascular disease entered this multicenter,randomized study:302 were randomly assigned to aspirin 1 group(50 mg/d),211 to aspirin 2 group (300 mg/d),232 to aspirin 3 group(1 000 mg/d), and 255 to controlled group.The follow-up period was 24～60 (average 30.5) months.Results The rate of stroke in aspirin group (average 10.9%) was lower than that in controlled group(19.6%) (P<0.01). The rate of death in aspirin group (average 2.5%) was lower than that in controlled group (7.9%) (P<0.01). Cornpared with controlled group, aspirin groups showed a reduction of 39% (average) in the risk of stroke and death (relativer risk 0.62,95% confidence interval 0.45～0.86). The rate of adverse drug effects in aspirin group was 23.4%.Conclusion Aspirin can reduce the rate of stroke and death, and the best dose was 50 mg/d.