Abstract: Objective To appraise the therapeutic efficacy and the safety of clopidogrel and aspirin in thesecondary prevention of ischemic cerebral stroke.Methods The patients with ischemic stroke were randomly divided into the clopidogrel groupand the aspirin group. Fifty-five patients were continuously collected for each group. Patients inthe clopidogrel group received clopidogrel 50mg once daily. Patients in the aspirin group receivedaspirin enteric-coated tablets 75mg once daily. The patients of the two groups have been followedup for one year; and the recurrences rate of ischemic stroke and the adverse drug reaction rates ofthe two groups were compared.Results The recurrences rate in the aspirin group is 13.5%, and the clopidogrel group is1.8%, the recurrences rates in the clopidogrel group is lower than that in the aspirin group(P =0.04); the adverse drug reaction rate in the aspirin group is 36.4%, and the clopidogrelgroup is 5.5%, the adverse drug reaction rate in the clopidogrel is lower that in the aspiringroup (P =0.001).Conclusion The therapeutic efficacy and the safety of clopidogrel in secondary prevention ofischemic stroke is better than aspirin.

Key words: Brain infarction; Secondary prevention; Clopidogrel; Aspirin

摘要： 目的 观察氯吡格雷和阿司匹林肠溶片在非心源性缺血性卒中二级预防中的疗效和安全性。方法 连续收集非心源性缺血性卒中患者并随机分为氯吡格雷组和阿司匹林组，每组55例患者，两组均给予卒中基础治疗。氯吡格雷组加用硫酸氢氯吡格雷口服，50 mg/d。阿司匹林组加用阿司匹林肠溶片口服，75 mg/d。随访1年内两组缺血性卒中复发率和药物不良反应发生率。结果 阿司匹林组卒中复发率为13.5%，而氯吡格雷组复发率为1.8%，差异有统计学意义（P =0.04）；阿司匹林组不良反应发生率为36.4%，氯吡格雷组不良反应发生率为5.5%，差异有统计学意义（P =0.001）。结论 氯吡格雷在非心源性缺血性卒中二级预防中的疗效优于阿司匹林，安全性较高。

关键词: 脑梗死; 二级预防; 氯吡格雷; 阿司匹林