英国研究者3月8日报告称，患者在接受手术使颈部动脉栓塞畅通前服用阿斯匹林及一种抗梗塞药物，能够降低术后中风的危险。

该手术的目的是防止中风，但是其本身有些小风险，会导致约6%的病人在术后出现中风现象。

研究者在医学刊物《循环》（Circulation）上发表报告称，病人在手术前服用阿斯匹林及防血管堵塞药物波立维——氯吡格雷（clopidogrel）能够降低这一风险。

研究领导人、英国莱斯特大学的奈勒（Ross Naylor）在声明中称：“这种并发症在以前被认为难以预料又无法预防的，但现在对其进行预防已经是能够做到的了。”

“但需要强调的是，这是一个小型的研究，还不足以对氯吡格雷预防中风的临床效果做出有效的衡量。”Beneficial Effects of Clopidogrel Combined With Aspirin in Reducing Cerebral Emboli in Patients Undergoing Carotid Endarterectomy.

David A. Payne, Chris I. Jones, Paul D. Hayes, Matthew M. Thompson, Nicholas J. London, Peter R. Bell, Alison H. Goodall, and A. Ross Naylor.

From the Departments of Surgery and Cardiovascular Sciences, University of Leicester, Leicester, UK.

Background--Postoperative thromboembolic stroke affects 2% to 3% of patients undergoing carotid endarterectomy (CEA) and is preceded by 1 to 2 hours of increasing cerebral embolization. Previous work has demonstrated that high rates of postoperative embolization are associated with increased platelet reactivity to adenosine 5`-diphosphate (ADP). Our hypothesis was that preoperative administration of the platelet ADP antagonist clopidogrel could reduce postoperative embolization. Methods and Results--One hundred CEA patients on routine aspirin therapy (150 mg) were randomized to 75 mg clopidogrel (n=46) or placebo (n=54) the night before surgery. Platelet response to ADP was assessed by whole-blood flow cytometry. The number of emboli detected by transcranial Doppler within 3 hours of CEA was independently quantified. Time taken from flow restoration to skin closure was used as an indirect measure of the time to secure hemostasis. In comparison with placebo, clopidogrel produced a small (8.8%) but significant reduction in the platelet response to ADP (P<0.05) while conferring a 10-fold reduction in the relative risk of those patients having >20 emboli in the postoperative period (odds ratio, 10.23; 95% CI, 1.3 to 83.3; P=0.01, Fisher’s exact test). However, in the clopidogrel-treated patients, the time from flow restoration to skin closure (an indirect marker of hemostasis) was significantly increased (P=0.04, Fisher’s exact test), although there was no increase in bleeding complications or blood transfusions. Conclusions--This is the first study to show that a CEA patient’s postoperative thromboembolic potential can be significantly reduced by targeted preoperative antiplatelet therapy without increasing the risk of bleeding complications.