阿司匹林对脑室旁脑白质疏松患者新发脑卒中的影响

摘要

Objective To investigate the effect of aspirin on the prevention of stroke in patients with periventricular leukoaraiosis.Methods Four hundred lacunar infarction patients with periventricular leukoaraiosis were randomly divided into the treatment group (200 cases,aspirin) and the control group.The cases in the treatment group received aspirin 100 mg daily for 1 year,and patients in control group didn't take antiplatelet or anticoagulant drugs.All cerebrovascular events occurred in patients prescribed in one year.In all participants we measured the score of the Montreal Cognitive Assessment,the severity of periventricular leukoaraiosis and the number of cerebral microbleeds at the begining and the ending of this trial.Results The numbers of cerebral microbleeds in the treatment group were significantly higher than those in the control group.The incidence of acute cerebral infarction in the treatment group was significantly lower than that in the control group.There were no significant differences in the the incidence of acute cerebral hemorrhage,the score of the Montreal Cognitive Assessment and the severity of periventricular leukoaraiosis between two groups.Conclusion Among lacunar infarction patients with periventricular leukoaraiosis,aspirin can reduce the risk of acute cerebral infarction and has no side effect.%目的 探讨阿司匹林对脑室旁脑白质疏松患者新发脑卒中的影响.方法 选取伴腔隙性梗死的脑室旁脑白质疏松患者400例,随机分为阿司匹林组(200例)和对照组(200例).阿司匹林组服用阿司匹林肠溶片100 mg,1次/d,持续1 a.对照组不服用任何抗血小板药或抗凝药.记录1 a内患者发生急性脑血管疾病和神经功能缺损情况.记录入组时及1 a后受试者的认知功能(MoCA评分)、白质疏松的严重程度及脑微出血.结果 阿司匹林组1 a后脑微出血的数量明显大于对照组,阿司匹林组急性脑梗死的发生率明显小于对照组(P<0.05),脑出血发生率差异无统计学意义(P>0.05).脑卒中患者1 a后神经功能缺损程度(NIHSS评分)阿司匹林组和对照组差异无统计学意义(P>0.05),2组白质疏松程度评、认知功能差异无统计学意义(P>0.05).结论 采用阿司匹林对伴脑室旁白质疏松的腔隙性梗死患者缺血性卒中的一级或二级预防可使新发脑梗死疾病显著减少,且不加快白质疏松进程及增加颅内出血.