缺血性脑卒中／TIA 二级预防抗血小板药物规范化应用的中国专家共识PPT.ppt

解读：缺血性卒中／TIA 二级预防抗血小板药物规范化应用的中国专家共识;; 1 心源性脑栓塞的预防----抗栓药物;1 心源性脑栓塞的预防----抗栓药物;提高包括房颤在内的心源性脑梗死的诊断率;非心源性脑栓塞二级预防 抗凝 Vs ASA;非心源性栓塞的缺血性卒中或TIA患者（脑动脉粥样硬化性、腔隙性和病因不明性），为减少卒中复发或其他血管事件的风险，建议使用抗血小板药物，而不能用其他任何药物替代（I类推荐，A级证据）。 急性缺血性卒中/TIA后应尽早启动抗血小板治疗（I 类推荐，A级证据）。 如果没有禁忌症，应该长期使用抗血小板药物（I类推荐，A级证据）。;2.3 Aggenox? + ASA Vs ASAEuropean Stroke Prevention Study (ESPS) 2;;? 标准疗法总是包括阿司匹林, 同时可以包括肝素, LMWH, 随机化后 GP IIb/IIIa 抑制剂, β受体阻滞剂, ACE-抑制剂, 降血脂药物, 和/或 其他由内科医生决定的 治疗或干预 (如 PTCA, CABG). ;25;波立维75mg安全性至少与阿司匹林相当;ESO 2008 二级预防Antithrombotic Therapy ;Class I Recommendations 2. Old recommendation: Aspirin (50 to 325 mg/d), the combination of aspirin and extended-release dipyridamole, and clopidogrel are all acceptable options for initial therapy ( IIa, A). ;3. Old recommendation: Compared with aspirin alone, both the combination of aspirin and extended-release dipyridamole and clopidogrel are safe. The combination of aspirin and extended-release dipyridamole is suggested over aspirin alone (Class IIa, Level of Evidence A). ;Class II Recommendations Class III Recommendation The addition of aspirin to clopidogrel increases the risk of hemorrhage. Combination therapy of aspirin and clopidogrel is not routinely recommended for ischemic stroke or TIA patients unless they have a specific indication for this therapy (ie, coronary stent or acute coronary syndrome) (I). ;ASA: effective. IA Aggenox? ASA IA Plavix? Clopidogrel ASA IIb; - ;一级观察终点: 卒中复发％，两组比较9.0% vs. 8.8%, HR1.01，95％CI 0.92~1.11, P=0.783;(0.8%);;Plavix? = Aggenox?;ASA + Clopidogrel ASA 弱证据，ASA + Clopidogrel ASA 弱证据，ASA + Clopidogrel ASA ASA + Clopidogrel Plavix?;脑梗死的病因及发病机制分型;;Pathogenesis of ICAS related infarction is different from SAD, and CE ;Pathogenesis of ICAS related infarction is different from SAD, and CE;Pathogenesis of ICAS related infarction is different from SAD, and CE;Pathogenesis of ICAS related infarction is different from SAD, and CE;Wong KS. Use of Transcranial Doppler Ul