【摘要】 目的　观察噻氯匹啶 (TIC)预防缺血性卒中 (IS)的临床疗效及安全性 ,并与小剂量阿司匹林(ASA)预防 IS的疗效作对照。方法　选择 32 9例 TIA与轻型 IS病人 ,随机分为 TIC组 (16 5例 )与 ASA组(16 4例 )。TIC组口服 TIC2 5 0 mg/d,ASA组口服 ASA5 0 mg/d,禁服其他抗血小板药物。每例病人 1～ 2个月随访 1次 ,共随访 6～ 18个月。结果　 TIC组卒中与死亡率 (8.3% )低于 ASA组 (14.9% ) ,TIC组卒中与死亡危险性较 ASA组降低 44 .3%。TIC组 IS、心梗发生率 (7.0 % )显著低于 ASA组 (14.8% ) (P<0 .0 5 ) ,TIC组 IS、心梗危险性较 ASA组下降 5 2 .7%。TIC2 5 0 mg/d、ASA5 0 mg/d长期服用有一定的副作用 ,总发生率分别为 6 .9%、11.0 % ,两组间无显著差异 (P>0 .0 5 )。结论　 TIC预防 IS疗效明显优于 ASA,其副作用发生率与 ASA无显著差异性 ,故推荐 TIC可作为预防 IS的一线药物。更多还原

【Abstract】 Objective To observe the clinical therapeutic effectiveness and safety of ticlopidine (TIC) in the prevention of ischemic stroke (IS) and to compare with the effect of low dose aspirin (ASA) for prevention IS.Methods 329 patients with TIAand mild IS were randomly divided into TIC group for 165 cases and ASA group for 164 cases.The patients in TIC group took 250 mg TIC per day or the patients in ASA group took 50 mg ASA per day,they were forbidden to take any other antiplatelet drugs.Each patient was followed up once in one to two months.Follow up lasted for 6 to 18 months.Results Stroke and mortality 8.3% in TIC group was lower than ASA group (14 9%).Stroke and death risk in TIC group was lower than ASA group (44.3%).The prevalence for IS or myocardial infarction in TIC group (7.0%) was lower than ASA group(14 8%)(P<0.05).The risk of IS,myocardial infarction reduced 52.7% as compared with ASA group. There was certain side effect in taking TIC(250 mg/d),ASA (50 mg/d) for long term,total prevalence were 6 9% and 11.0% during the trial ,but there was no significant difference(P>0.05).Conclusion Therapeutic effectiveness for the prevention IS of TIC was better than ASA, there was no obvious difference between the incidence of its side effects in TIC group and ASA group,so TIC could serve as a first line drug for preventing IS.更多还原