Objective To evaluate the effects of treatments with clopidogrel plus aspirin ( dual therapy ) on early neurological deterioration ( END ) and outcomes at 6 months in patients with acute large artery atherosclerosis ( LAA ) stroke .Methods A total of 574 patients with LAA stroke were randomly assigned to receive either dual therapy or aspirin alone (monotherapy).The primary outcome was END.Secondary outcomes included recurrent ischemic stroke (RIS) and outcomes at 6 months.Results The prevalence of END and RIS was lower in patients on dual therapy than in those on monotherapy during the 30 days.At 6 months,dual therapy improved outcomes among older patients and those with symp-tomatic stenosis in the posterior circulation and basilar artery .Conclusion Clopidogrel plus aspirin is superior to aspirin alone for reducing END and RIS within 30 days and improves outcomes in certain subgroups at 6 months.%目的：评估阿司匹林联合氯吡格雷治疗对于急性大动脉粥样硬化型卒中患者早期神经功能恶化和6m结局的影响。方法574例大动脉粥样硬化型卒中患者被随机分配到联合治疗组或阿司匹林单药治疗组。主要结局指标是早期神经功能恶化。次要结局指标是复发缺血性卒中和6 m结局。结果联合治疗组30 d时的神经功能恶化率和卒中复发率低于单药治疗组。联合治疗能够改善老年患者，症状性后循环和基底动脉狭窄患者6 m随访结局。结论阿司匹林和氯吡格雷联合治疗在减少30 d时神经功能恶化率和缺血性卒中复发率方面优于阿司匹林单药治疗，同时联合治疗也能改善特定亚组的6m结局。
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