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【文摘发布】亚洲地区低分子量肝素与阿司匹林
Authors: Prof Ka Sing Wong FRCP a , Christopher Chen FRCP b, Ping Wing Ng FRCP c, Tak Hong Tsoi FRCP d, Ho Lun Li MRCP e, Wing Chi Fong MRCP f, Jonas Yeung FRCP g, Chi Keung Wong FRCP h, Kin Keung Yip MRCP i, Hong Gao MD j and Hwee Bee Wong MSc j, for the FISS-tris Study Investigators
Resourse: Lancet Neurology 2007; 6:407-413
Summary
Background
Acute stroke patients with large artery occlusive disease (LAOD) have a distinct pathophysiology and may respond differently to anticoagulation treatments. We compared the efficacy of a low-molecular-weight heparin (LMWH), nadroparin calcium, with aspirin in Asian acute stroke patients with LAOD.
Methods
Acute ischaemic stroke patients with onset of symptoms less than 48 h and LAOD (diagnosed by transcranial doppler imaging, carotid duplex scan, or magnetic resonance angiography) were recruited. Patients were randomly assigned to receive either subcutaneous nadroparin calcium 3800 anti-factor Xa IU/0·4 mL twice daily or oral aspirin 160 mg daily for 10 days, and then all received aspirin 80–300 mg once daily for 6 months. This study is registered at www.strokecenter.org/trials (number 493).
Findings
Among 603 patients recruited, 353 (180 LMWH, 173 aspirin) had LAOD (300 had intracranial LAOD only, 42 had both intracranial and extracranial disease, and 11 had extracranial disease only). The proportion of patients with good outcomes at 6 months (Barthel index ≥85) was 73% in the LMWH group and 69% in the aspirin group (absolute risk reduction 4%; 95% CI −5 to 13). Analysis of prespecified secondary outcome measures showed a benefit in outcome for LMWH versus aspirin on the modified Rankin scale dichotomised at 0–1 (odds ratio 1·55, 95% CI 1·02–2·35). Haemorrhagic transformation of infarct and severe adverse events were similar in both groups. Post-hoc analyses of patients without LAOD, and all treated patients, showed similar proportions with a good outcome in aspirin and LMWH groups (78% vs 79% and 73% vs 75%, respectively).
Interpretation
Overall, the results do not support a significant benefit of LMWH over aspirin in patients with LAOD. The benefits indicated in most outcome measures warrant further investigation into the use of anticoagulation for acute stroke in patients with large artery atherosclerosis, particularly in intracranial atherosclerosis. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title: Low-molecular-weight heparin compared with aspirin for the treatment of acute ischaemic stroke in Asian patients with large artery occlusive disease: a randomised study
标题：亚洲地区低分子量肝素与阿司匹林治疗大动脉闭塞导致的急性缺血性卒中的随机对照研究
Authors: Prof Ka Sing Wong FRCP a , Christopher Chen FRCP b, Ping Wing Ng FRCP c, Tak Hong Tsoi FRCP d, Ho Lun Li MRCP e, Wing Chi Fong MRCP f, Jonas Yeung FRCP g, Chi Keung Wong FRCP h, Kin Keung Yip MRCP i, Hong Gao MD j and Hwee Bee Wong MSc j, for the FISS-tris Study Investigators
Resourse: Lancet Neurology 2007; 6:407-413
文章来源：柳叶刀神经病学2007; 6:407-413
Summary
摘要
Background
背景：
Acute stroke patients with large artery occlusive disease (LAOD) have a distinct pathophysiology and may respond differently to anticoagulation treatments. We compared the efficacy of a low-molecular-weight heparin (LMWH), nadroparin calcium, with aspirin in Asian acute stroke patients with LAOD.
大动脉闭塞疾病(LAOD)导致的急性卒中患者有不同的病理生理情况，并且可能对抗凝剂治疗反应不同。我们比较了低分子量肝素(LMWH)那屈肝素钙，和阿司匹林在亚洲有LAOD的急性卒中患者中的治疗作用。
Methods
方法
Acute ischaemic stroke patients with onset of symptoms less than 48 h and LAOD (diagnosed by transcranial doppler imaging, carotid duplex scan, or magnetic resonance angiography) were recruited.
新近出现LAOD（通过经颅多普勒显像，颈动脉双功超声扫描，或者磁共振成像扫描诊断），且卒中发病症状持续时间少于48h的急性缺血性卒中患者被纳入研究。
Patients were randomly assigned to receive either subcutaneous nadroparin calcium 3800 anti-factor Xa IU/0•4 mL twice daily or oral aspirin 160 mg daily for 10 days, and then all received aspirin 80–300 mg once daily for 6 months. This study is registered at www.strokecenter.org/trials (number 493).
患者被随机分组为接受皮下注射那屈肝素钙3800Xa IU/0•4 mL每日两次或者口服阿司匹林每日160 mg，共治疗10天，然后所有组都接受一日一次的80–300 mg阿司匹林治疗，持续6个月。这项研究注册在www.strokecenter.org/trials (编号493)。
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作者:admin@医学,生命科学 2010-11-19 05:11
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