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目的：探讨急性缺血性脑卒中早期抗血小板治疗，对降低病人病死率、改善机体残疾率的临床疗效。本试验简称CAST临床试验。方法：采取多中心、随机、双盲治疗。对发病48小时内的急性缺血性脑卒中，经头颅计算机断层摄影术（CT）或临床检查基本排除出血性脑卒中即可入选。每日口服阿司匹林160mg或安慰剂4周。结果：自1993年11月至1997年4月全国413家医院共入选21106例病人。治疗期间阿司匹林组死亡343例，较对照组（死亡398例）下降14.0％（P=0．04）。再发缺血性脑卒中阿司匹林组显著低于对照组（1．6％比2．1％，P=0．01）。出血性脑卒中的发生，阿司匹林组较对照组略有增加，但差别不显著（1．1％比0．9％，P＞0．1）。结论：本项研究显示，对急性缺血性脑卒中病人进行早期抗血小板治疗，可显著降低住院期间死亡率及再发脑卒中发生率，并在一定程度上促进病人的功能康复。
Objective: To investigate the early anti-platelet therapy in acute ischemic stroke, and to reduce the mortality of patients and improve the clinical efficacy of the disability rate. This trial referred to CAST clinical trials. Methods: Multi-center, randomized, double-blind treatment. For acute ischemic stroke within 48 hours of onset, hemorrhagic stroke can be selected by skull computed tomography (CT) or clinical examination. 160 mg daily aspirin or placebo for 4 weeks. Results: From November 1993 to April 1997, a total of 21,106 patients were enrolled in 413 hospitals nationwide. In the aspirin group, 343 patients died during the treatment period, which was 14.0% lower than that of the control group (398 deaths) (P = 0.04). Secondary ischemic stroke in aspirin group was significantly lower than the control group (1.6% vs 2.1%, P = 0.01). The occurrence of hemorrhagic stroke, aspirin group slightly increased compared with the control group, but the difference was not significant (1.1% vs 0.9%, P> 0.1). CONCLUSIONS: This study shows that early antiplatelet therapy in patients with acute ischemic stroke can significantly reduce the rate of hospital-acquired mortality and recurrent stroke and to a certain extent promote functional rehabilitation.