伴有心房纤颤的缺血性脑卒中患者的卒中二级预防中抗凝治疗和抗血小板治疗的比较

目的观察比较阿司匹林、氯吡格雷及华法林在伴有心房纤颤的缺血性脑卒中患者的卒中二级预防中的疗效。方法将235例伴有心房纤颤的缺血性脑卒中患者按治疗方法的不同随机分为阿司匹林组、氯吡格雷组和华法林组，阿司匹林组给予阿司匹林口服治疗，氯吡格雷组给予氯吡格雷口服治疗、华法林组给予华法林口服治疗，观察3组患者卒中复发率及出血性并发症的概率，进行比较分析。结果随访观察1年，阿司匹林组卒中复发率为15．0％，出血率为2．5％；氯吡格雷组复发率为4．0％，出血率为0；华法林组卒中复发率3．8％，出血率3．8％。结论华法林、氯吡格雷对于伴有心房纤颤的缺血性脑卒中患者卒中的二级预防效果好，安全性高。

Objective To observe the curative effects of Aspirin,Clopidogrel and Warfarin in the sec- ond-level prevention of stroke of ischaemic stroke patients with atrial fibrillation. Methods A total of 235 cases ischaemic stroke patients with atrial fibrillation were at random divided into Aspirin group, Clopidogrel group and Warfarin group upon different treatment methods. The patients in Aspirin group, Clopidogrel group and Warfarin group were treated by orally taking Aspirin, Clopidogrel and Warfarin respectively. The recurrence rates of stroke and probabilities of hemorrhagic complications in 3 groups were observed, then making a comparative analysis for them. Results After 1-year＇ s follow-up survey,the recurrence rate of stroke in Aspirin group was 15.0% and hemorrhage rate was 2.5% ; the recurrence rate of stroke in Clopidogrel group was 4.0% and hemorrhage rate was 0 ; the recurrence rate of stroke in Warfarin group was 3.8% and hemorrhage rate was 3.8%. Conclusion The use of Warfarin and Clopidogrel in the second-level prevention of stroke of ischaemic stroke patients with at- rial fibrillation has good curative effect and high safety.