抗血小板治疗可延长颈动脉分叉内膜切除术后的生存期。临床系列分析及随后的对照试验。
Antiplatelet treatment prolongs survival after carotid bifurcation endarterectomy. Analysis of the clinical series followed by a controlled trial.
作者信息
Kretschmer G, Pratschner T, Prager M, Wenzl E, Polterauer P, Schemper M, Ehringer H, Minar E
机构信息
First Clinic of Surgery and Angiology Unit, University of Vienna, Austria.
出版信息
Ann Surg. 1990 Mar;211(3):317-22. doi: 10.1097/00000658-199003000-00002.
To examine the role of antiplatelet drugs in the secondary prevention of arteriosclerotic arterial disease following carotid endarterectomy, a clinical series (n = 252) was analyzed. Based on these results a prospective randomized trial was initiated, comparing the effect of antiplatelet drugs (acetyl-salicylic acid [ASA] 1000 mg/day) versus untreated controls. In both investigations patient survival was the primary end point. A cardiac risk (n = 91) implied a significant reduction in patient survival (p less than 0.019 Breslow, p less than 0.052 Mantel). Antiaggregating drugs prolonged survival in the collective series (p less than 0.0001 Breslow, p less than 0.0002 Mantel) and in the subgroup of patients with cardiac risk (p less than 0.014 Breslow, p less than 0.020 Mantel) as well. In the prospective trial 66 patients were recruited, receiving ASA (n = 32) versus no therapy (n = 34). During follow-up 15 patients died, 4 in the treatment, and 11 in the control group. Between both groups there was a significant difference in the probability of survival (p less than 0.021 Breslow, p less than 0.048 Mantel).
为研究抗血小板药物在颈动脉内膜切除术后动脉硬化性动脉疾病二级预防中的作用，分析了一个临床系列（n = 252）。基于这些结果开展了一项前瞻性随机试验，比较抗血小板药物（乙酰水杨酸[ASA]1000毫克/天）与未治疗对照组的效果。在两项研究中，患者生存率均为主要终点。心脏风险（n = 91）意味着患者生存率显著降低（Breslow检验p<0.019，Mantel检验p<0.052）。抗聚集药物在总体系列中延长了生存期（Breslow检验p<0.0001，Mantel检验p<0.0002），在有心脏风险的患者亚组中也延长了生存期（Breslow检验p<0.014，Mantel检验p<0.020）。在前瞻性试验中，招募了66例患者，接受ASA治疗的有32例，未接受治疗的有34例。随访期间，15例患者死亡，治疗组4例，对照组11例。两组之间的生存概率存在显著差异（Breslow检验p<0.021，Mantel检验p<0.048）。
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