Hankey Graeme J, Eikelboom John W
Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Australia.
Neurology. 2005 Apr 12;64(7):1117-21. doi: 10.1212/01.WNL.0000156357.50448.8A.
Antiplatelet therapy is effective for reducing the risk of recurrent stroke and other serious vascular events in patients with recent TIA and ischemic stroke. Effective antiplatelet agents include aspirin, ticlopidine, clopidogrel, dipyridamole, and the combination of aspirin and dipyridamole. The combination of aspirin and clopidogrel is more effective than aspirin in patients with acute coronary syndrome but is more hazardous than clopidogrel alone in patients with recent TIA and ischemic stroke. Further trials are needed to determine whether the combination of aspirin and clopidogrel may have a role immediately after TIA and ischemic stroke in patients with symptomatic large artery atherothromboembolism and continued for approximately 3 months before switching to less hazardous antiplatelet regimens.
抗血小板治疗对于降低近期短暂性脑缺血发作（TIA）和缺血性卒中患者复发性卒中及其他严重血管事件的风险是有效的。有效的抗血小板药物包括阿司匹林、噻氯匹定、氯吡格雷、双嘧达莫以及阿司匹林与双嘧达莫的联合制剂。在急性冠状动脉综合征患者中，阿司匹林与氯吡格雷联合使用比单用阿司匹林更有效，但在近期TIA和缺血性卒中患者中，该联合用药比单用氯吡格雷更具危险性。对于有症状的大动脉粥样硬化血栓形成性栓塞患者，在TIA和缺血性卒中后立即使用阿司匹林与氯吡格雷联合治疗并持续约3个月，之后改用危险性较小的抗血小板治疗方案是否有益，还需要进一步的试验来确定。
