【摘要】 目的探讨阿司匹林对原发性高血压伴阵发性心房颤动血栓栓塞的预防作用。方法符合标准的原发性高血压伴阵发性心房颤动病人400例随机分成阿司匹林组和安慰剂组,每组各200人,在治疗原发性高血压等疾病的基础上采用双盲法进行肠溶阿司匹林(0.3g/d)或安慰剂(0.3g/d)治疗并进行随访。主要终检标准发生血栓栓塞。评估阿司匹林或安慰剂对血栓栓塞的预防作用,用Kaplan-Meier曲线表示,并作对数秩检验。结果400例病人中平均年龄59岁,平均随访3.6年,血栓栓塞61例,总血栓栓塞率15.3%,平均年血栓栓塞率4.3%。其中,阿司匹林组平均随访3.7年,血栓栓塞18例,血栓栓塞率9.0%,平均年血栓栓塞率2.4%;安慰剂组平均随访3.6年,血栓栓塞43例,血栓栓塞率21.5%,平均年血栓栓塞率6.0%。阿司匹林组血栓栓塞率明显低于安慰剂组血栓栓塞率(对数秩检验统计量为12.4,υ=1,P=0.0004)。结论阿司匹林能有效降低原发性高血压伴阵发性心房颤动血栓栓塞率。更多还原

【Abstract】 Objective To investigate the effect of aspirin on the incidence of thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.MethodsFour hundred hypertensive patients with paroxysmal atrial fibrillation (mean age 59 years) free of thromboembolic events were randomized assigned to receive aspirin (0.3 g/d) or placebo. Cerebral thromboembolism,including transient ischemic attack and embolism of peripheral arteries were defined as primary outcomes. Event-free survival curves were estimated by Kaplan-Meier curve. Results During 3.6 years follow-up,primary outcomes occurred in 61 patients (4.3% per year). Aspirin significantly reduced the incidence of primary outcome as compared with placebo group( 9.0% vs 21.5%,P<0.001). Kaplan-Meier curve also showed greater free thromboembolism rate in the aspirin treatment group(υ= 1,P=0.0004). Conclusion Aspirin significantly prevents the risks for thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.更多还原