Department of Neurosurgery, Thomas Jefferson University, Jefferson Hospital for Neurosciences, Philadelphia, Pennsylvania, USA.
World Neurosurg. 2011 Jul-Aug;76(1-2):100-4; discussion 59-60. doi: 10.1016/j.wneu.2011.02.010.
To compare outcomes in the setting of spontaneous intracerebral hemorrhage (ICH) in patients taking aspirin (acetylsalicylic acid [ASA]) versus patients taking clopidogrel before hospitalization.
Patients admitted to the neurosurgical service with a spontaneous ICH while taking an antiplatelet agent were prospectively identified and retrospectively reviewed. Two groups of 28 consecutive patients taking ASA or clopidogrel on admission were ultimately evaluated.
Patients in the clopidogrel group had a mean age of 72.6 years, and patients in the ASA group had a mean age of 65.8 years (P=0.04). Patients taking clopidogrel before hospitalization were significantly more likely than patients taking ASA to experience an increase in hematoma volume (P=0.05). Patients in the ASA group trended toward being discharged to home more frequently than other destinations (P=0.07). The in-hospital mortality rates in this series were 14.3% for the ASA group and 28.6% for the clopidogrel group. However, this association did not reach statistical significance (P=0.19).
In this study, patients taking clopidogrel showed more hematoma expansion, higher in-hospital mortality rates, and a decreased likelihood of a home discharge compared with patients taking ASA alone.
比较在自发性脑出血（ICH）患者中，在住院前服用阿司匹林（乙酰水杨酸）与氯吡格雷的患者的治疗效果。
前瞻性识别并回顾性研究了在神经外科病房因服用抗血小板药物而发生自发性 ICH 的住院患者。最终评估了两组各 28 例连续服用 ASA 或氯吡格雷的患者。
氯吡格雷组患者的平均年龄为 72.6 岁，ASA 组患者的平均年龄为 65.8 岁（P=0.04）。与服用 ASA 的患者相比，服用氯吡格雷的患者在住院前血肿体积增加的可能性显著更高（P=0.05）。ASA 组患者出院回家的频率趋势高于其他目的地（P=0.07）。本研究中，ASA 组的住院死亡率为 14.3%，氯吡格雷组为 28.6%。然而，这种关联没有达到统计学意义（P=0.19）。
在这项研究中，与单独服用 ASA 的患者相比，服用氯吡格雷的患者表现出更大的血肿扩张、更高的住院死亡率，以及出院回家的可能性降低。
