阿司匹林对低踝臂指数人群卒中一级预防研究.docVIP

阿司匹林对低踝臂指数人群卒中一级预防研究 　　【摘要】 目的 研究阿司匹林对低踝臂指数(ankle brachial index, ABI)人群卒中一级预防的作用。方法 筛查健康体检人群中低踝臂指数者(ABI≤0.9)，随机分为阿司匹林治疗组和未接受阿司匹林治疗的对照组，随访观察18个月，比较两组人群缺血性卒中发病率的差异。结果 1090例符合入组标准的低踝臂指数人群纳入本研究，496例接受阿司匹林治疗，与对照组相比，治疗组的年龄［(60±8.9）岁比(59±9.1)岁，P=0.321］、性别(男性：58.1%比59.5%，P=0.57)差异无统计学意义。随访18个月，治疗组首发脑梗死患者11例/457例(2.4%)，与对照组(16/563例，2.8%)相比差异无统计学意义(P=0.667)；两组患者中各有2例患者出现症状性颅内出血；治疗组主要终点事件和次要终点事件中缺血性血管事件的总体发病率(5.7%比9.0%，P=0.044)和短暂性脑缺血发作的发病率(1.3%比3.2%，P=0.048)显著低于对照组。结论 低踝臂指数人群进行阿司匹林一级预防并不能有效预防缺血性卒中。? 　　【关键词】 　　踝臂指数;阿司匹林;一级预防 　　?? 　　 　　Aspirin for primary prevention of stroke in general population with low ankle brachial index 　　 　　WANG Yan?ling,XU Min,ZHANG Guang?yu,et al. 　　Department of Neurology,The People’s Hospital of Cangzhou City,Cangzhou 061001,China 　　? 　　【Abstract】 Objective 　　To evaluate the effect of aspirin for primary prevention of stroke in general population with low ankle brachial index(ABI).Methods Screening individuals with low ABI (ABI＜0.9) were divided into therapeutic group to receive aspirin and control group to receive any medicine except aspirin or other anti?platelet drugs. Evaluted the effect of aspirin for stroke primary prevention after following up 18 months.Results 1090 individuals were recruited in this study. 496 received aspirin were divided into therapeutic group, the mean age ［(60±8.9)year VS (59±9.1)year, P=0.321］ and male proportion(58.1%VS 59.5%, P=0.57) of therapeutic group were similar with control group. The proportion of first?ever stroke in therapeutic group was not significantly lower than control group(11/457 VS 16 /563, P=0.667). Two individuals in each group diagnosed as symptomatic intractable hemorrhage. Total proportion of vascular events of primary or secondary end?point events was significantly lower in therapeutic group when compared with control group (5.7%VS 9.0%, P=0.044). There were fewer patients having transient ischemic attack in therapeutic group than in control group(1.3%VS 3.2%, P=0.048).Conclusion T