Objective To study the effect and security of combined antiplatelet therapy for the prevention of cerebral infarction and recurrence in symptomatic cerebral artery stenosis patients without stent implantation. Methods A total of 1 126 incipient patients who suffered from symptomatic cerebral artery stenosis were randomly divided into treatment group ( 787 cases ) and control group ( 339 cases ). There were the same basic secondary prevention measures in the two groups. The treatment group took dipyridamole after meals and aspirin for antiplatelet therapy. The control group took aspirin for antiplatelet therapy alone. The functional health, endpoint event, adverse reactions after three - year, five - year treatment were compared between the two groups. Results The treatment group had higher functional health than the control group after 3 - and 5 - year follow - up( P < 0. 05 ). In the treatment group, the occurrence and recurrence of cerebral infarction, cardiac events were significantly lower than the control group( P < 0. 01 ). The 5 - year mortality rate of the treatment group were lower than the control group ( P <0. 05 ). The two groups had statistical difference in headache incidence( P < 0. 05 ), and had no statistical difference in dizziness, thermal face, subcutaneous hemorrhage, gastrointestinal hemorrhage,urinary tract hemorrhage and intracranial hemorrhage ( P > 0. 05 ). Conclusion The combined antiplatelet therapy can effectively reduce the incidence of cerebral infarction and recurrence in symptomatic cerebral artery stenosis patients without stent implantation. The treatment is safe and reliable with few adverse reactions.%目的 观察联合抗血小板治疗对预防症状性脑动脉狭窄患者脑梗死发生及复发的效果与安全性.方法 将初发的症状性脑动脉狭窄患者1 126例,随机分为治疗组787例,对照组339例.2组基本二级预防措施一致.治疗组实施双嘧达莫餐后即服联合阿司匹林抗血小板治疗;对照组实施单纯阿司匹林抗血小板治疗.3、5年随访后对其功能健康水平、终点事件、不良反应分别进行评定.结果 随访3年、5年治疗组功能健康水平高于对照组(P＜0.05),脑梗死发生和复发、心脏事件均明显低于对照组(P＜0.01),5年总病死率低于对照组(P＜0.05).2组头痛发生率差异有统计学意义(P＜0.05),余不良反应2组差异无统计学意义(P＞0.05).结论 联合抗血小板治疗预防症状性脑动脉狭窄未行支架植入患者脑梗死发生及复发效果显著,不良反应少,安全、可靠.
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