阿司匹林与脑出血危险性的关系

Aspirin and risk of brain hemorrhage

目的 研究国人服用阿司匹林与脑出血危险性的关系.方法 采用临床病例回顾分析方法,以1986年1月～2003年12月收住院TIA患者及腔隙性脑梗死患者为研究对象,分为服药组与未服药组,以出现新的脑梗死或脑出血;发生急性心肌梗死、TIA或死亡;中止服药或截至观察时间结束时为观察终点,观察脑出血的发生情况.结果 小剂量阿司匹林服药组（25～100mg/d）与对照组脑出血发生率之间无明显差别,P=0.316＞0.05,RR=1.314,95%CI=0.771～2.242.中到大剂量阿司匹林服药组（300～900 mg/d）与对照组脑出血发生率之间有明显差别,P=0.000＜0.05,RR=4.610,95%CI=2.198～9.670.小剂量阿司匹林组与中到大剂量阿司匹林组之间有明显差别,P=0.000＜0.05,RR=3.602,95%CI=1.874～6.924.结论 TIA或腔隙性脑梗死患者服用小剂量阿司匹林进行2级预防不会增加脑出血的危险性,服用中等剂量到大剂量阿司匹林可以增加脑出血的危险性.

Objective To study if Aspirin treatment in Asian people is associated with an increased risk of brain hemorrhage. Methods A retrospective study was applied. Subjects were the TIA and lacunar infarction paients of PUMC Hospital from January 1986 to December 2003. The patients were subgrouped as aspirin group and control group. The end point was a new stroke or brain hemorrhage,acute myocardial infarction,TIA or death ; terminal of drug or by time of the end of observation. The hemorrhagic events was observed. Results There was no significant difference between low-dose aspirin group and control group （P = 0. 316〉0.05, RR = 1. 314,95 %CI = 0. 771 -2. 242）. There was significant difference between medium to high dose group and control group（ p=0. 000 〈 0. 05, RR = 4.610,95 %CI = 2.198 - 9. 670）. There was significant difference between low-dose group and medium to high dose group（P=0.000〈0.05,RR=3.602,95% CI=1.874-6.924）.Conclusions Low-dose Aspirn therapy does not increase the risk of hemorrhagic stroke. However ,medium to high dose Aspirin therapy increases the risk.