阿司匹林对伴缺血性脑血管病颅内未破裂小动脉瘤影响研究

Research on the aspirin impacting on ischemic cerebrovascular disease together with the tiny non-ruptured intracranial aneurysm

目的评价缺血性脑血管病(ICVD)同时伴有直径≤5mm无症状性颅内未破裂小动脉瘤的患者,其口服阿司匹林致动脉瘤破裂的风险,为临床用药提供依据。方法收集2011年3月至2014年7月于沧州市中心医院神经内科住院的40~70岁(平均年龄56.3±9.7岁)伴有颅内单发无症状性未破裂小动脉瘤的脑梗死或TIA 63例,其随机分为口服阿司匹林和未口服阿司匹林两组,随访观察比较两组患者动脉瘤破裂及脑缺血事件复发的情况。结果两组患者63例,口服阿司匹林组32例,未口服阿司匹林组31例,随访1年。随访结果提示口服阿司匹林组患者脑缺血复发率明显低于未口服阿司匹林组[5/32 15.63%与17/31 54.84%,χ~2=10.65,P<0.005]。口服阿司匹林组和未口服阿司匹林组患者动脉瘤破裂致蛛网膜下腔出血的发生率无差异[2/32 6.25%与1/31 3.23%,χ~2=0.32,P>0.5]。结论患有脑梗死或TIA同时合并直径≤5mm无症状性颅内未破裂动脉瘤的患者,应常规口服阿司匹林预防ICVD的复发。

Objective To evaluate the risk that the patients suffered from ischemic cerebral vascular disease(ICVD) with the asymptomatic non-ruptured intracranial aneurysm( diameter≤5mm) take aspirin leading to rupture of aneurysms, which will provide the basis for clinical medication. Method Cerebral infarction or TIA patients with tiny asymptomatic non-ruptured intracranial aneurysm aged 40 to 70( Mean age: 56.3±9.7), total of 63 patients,hospitalized in neurology department. of Cangzhou Central Hospital from Mar. 2011 to Jul. 2014 were prospectively investigated.The patients were randomly divided into two groups, one group took aspirin,another group did not. The recurrence of cerebral ischemia events and ruptured intracranial aneurysm was compared between the two groups after follow-up. Results A total of 63 patients were followed up for 1 year, 32 patients of which took aspirin, but 31 patients did not. The result displayed the recurrence rate of cerebral ischemia of the group taking aspirin was lower than the group without taking aspirin[15.63 %(5/32) and 54.84 %(17/31),χ2=10.65,P<0.005].There was no discrepancy on the occurrence rate of aneurysm rupture leading to subarachnoid hemorrhage between the group taking aspirin and the group without taking aspirin[ 6.25%(2/32) and 3.23%(1/31),χ2=0.32,P>0.5]. Conclusion This study suggests the patients suffering from ICVD with the asymptomatic non-ruptured intracranial aneurysm( diameter≤5mm)to take aspirin to preventive against the recurrence of ICVD.