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缺血性卒中的二级预防是防止卒中复发的重要手段。大量研究证实,抗凝治疗在心源性栓塞(特别是心房颤动所致)的二级预防中有效。抗血小板治疗对其他类型缺血性卒中的二级预防有较好的疗效,而且双重抗血小板治疗已被越来越多地应用。降压和降脂治疗对预防缺血性卒中有积极的意义。控制血糖在缺血性卒中二级预防中的作用尚不确定。颈动脉内膜切除术(CEA)对狭窄超过70%的有症状颈动脉狭窄患者有益,对无症状患者是否有益仍存在争议。颈动脉血管内支架成形术逐渐成为CEA的有效替代治疗方法。
Secondary prevention of ischemic stroke is an important means of preventing the recurrence of stroke. A large number of studies have shown that anticoagulant therapy is effective in secondary prevention of cardioembolism, especially atrial fibrillation. Antiplatelet therapy for secondary prevention of other types of ischemic stroke has a good effect, and dual antiplatelet therapy has been more and more used. Antihypertensive and lipid-lowering treatment have a positive effect on the prevention of ischemic stroke. The role of blood glucose control in secondary prevention of ischemic stroke remains uncertain. Carotid endarterectomy (CEA) is beneficial for symptomatic carotid stenosis in more than 70% of patients with stenosis and is of benefit to asymptomatic patients. Carotid artery stenting has gradually become an effective alternative to CEA.