Colwell John A
Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Drugs Today (Barc). 2006 Jul;42(7):467-79. doi: 10.1358/dot.2006.42.7.1009900.
There is significant evidence that low-dose aspirin is effective in preventing the first myocardial infarction in men and ischemic stroke in women. There is also an increased risk for major gastrointestinal tract hemorrhage and a suggestive, but nonsignificant, increase in the risk for hemorrhagic stroke. If there is a history of ulcer disease or upper-gastrointestinal tract bleeding, Helicobacter pylori should be eradicated (if present) and a proton pump inhibitor used with aspirin therapy. In conclusion, the benefits of low-dose aspirin (75-162 mg/day) in the prevention of myocardial infarction in men and thrombotic stroke in women generally outweigh the risks of serious bleeding in adults with a coronary heart disease risk >1% per year or >1% in 10 years.
有充分证据表明，低剂量阿司匹林在预防男性首次心肌梗死和女性缺血性卒中方面有效。同时，发生重大胃肠道出血的风险增加，且出血性卒中风险有升高迹象，但不显著。如果有溃疡病或上消化道出血史，应根除幽门螺杆菌（如果存在），并在阿司匹林治疗时使用质子泵抑制剂。总之，对于每年冠心病风险>1%或10年内风险>1%的成年人，低剂量阿司匹林（75 - 162毫克/天）预防男性心肌梗死和女性血栓性卒中的益处通常超过严重出血的风险。
