双联抗血小板治疗非心源性缺血性脑卒中的疗效及安全性研究现状

A study of effects and safety of dual antiplatelet therapy on non-cardiac ischemic stroke

脑血管病是中国的第一大死因,其中约80%为缺血性脑卒中。在非心源性缺血性脑卒中的治疗和二级预防中,阿司匹林的疗效已被大量临床研究所证实,并受到各国指南推荐。但它的净效益并不理想,所以能否在非心源性缺血性脑卒中后患者服用阿司匹林的基础上短期合并应用氯吡格雷,以及联用能否取得更好疗效等问题都存在争议。本文结合近几年新近发表的国内外指南及经典临床试验,对双联抗小血板治疗非心源性缺血性脑卒中的疗效和安全性进行综述。

Cerebrovascular disease is the primary cause of disease leading to death in China, of them about 80% cases are due to ischemic stroke. In treatment and secondary prevention of non-cardiac ischemic stroke, the efficacy of aspirin has been extensively verified by clinical studies, and the clinical application of aspirin has been recommended by national guidelines, but its net benefit is still not ideal. It still remains as a controversial problem whether on top of the use of aspirin, a short-term supplement of clopidogrel might result in a better efficacy in the prevention and treatment of non-cardiac ischemic stroke. In present paper, the authors have summarized the efficacy and safety of dual antiplatelet therapy on non-cardiac ischemic stroke by reviewing the guidelines published worldwide in recent years as well as the result of classical clinical trials.