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【文摘发布】低分子肝素与阿司匹林对于有大动
Author：Wong KS, Chen C, Ng PW, Tsoi TH, Li HL, Fong WC, Yeung J, Wong CK, Yip KK, Gao H, Wong HB; FISS-tris Study Investigators.
Department of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China. ks-wong@cuhk.edu.hk
Resource: Lancet Neurol. 2007 May;6(5):381-2.
Abstract：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 >or=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.
PMID: 17434095
低分子肝素和小剂量阿司匹林是临床上治疗缺血性卒中常用药，对于合并有大动脉闭塞性疾病的患者，选择何种抗凝治疗效果好、并发症少、临床用药便利，这篇文章可以给我们一些提示 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 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
题目：低分子肝素与阿司匹林对于有大动脉闭塞性疾病亚洲人中患急性缺血性卒中的治疗比较
Author：Wong KS, Chen C, Ng PW, Tsoi TH, Li HL, Fong WC, Yeung J, Wong CK, Yip KK, Gao H, Wong HB; FISS-tris Study Investigators.
Department of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China. ks-wong@cuhk.edu.hk
作者：Wong KS, Chen C, Ng PW, Tsoi TH, Li HL, Fong WC, Yeung J, Wong CK, Yip KK, Gao H, Wong HB; FISS-tris Study Investigators.
中国香港特区香港大学医学部 ks-wong@cuhk.edu.hk
Resource: Lancet Neurol. 2007 May;6(5):381-2.
来源：柳叶刀－神经病学.2007 May;6(5):381-2.
Abstract：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.
摘要：背景：伴有大动脉闭塞性疾病(LAOD)的急性中风患者具有不同的病理生理特征，而且对抗栓治疗的反应迥异。我们比较了亚洲患有LAOD的急性中风患者对低分子量肝素(LMWH)，即那屈肝素钙及阿司匹林的治疗效果。
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).
方法：以出现症状小于48h并患有LAOD（通过经颅多普勒超声检查、颈动脉双功超声扫描,或者磁共振成像扫描诊断）的急性缺血性中风患者为研究对象。患者被随机分组两组，一组每日两次进行皮下注射那屈肝素钙3800抗因子Xa IU/0.4 mL，另一组口服阿司匹林每日160 mg，共治疗10天，然后两组都接受一日一次的80–300 mg阿司匹林治疗，为期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 2011-02-24 17:12
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