International Circulation:  What is the medical therapy for severe carotid stenosis to reduce large-vessel embolic stroke?
国际循环：严重颈动脉狭窄如何采用药物治疗以减少大血管血栓猝中的风险？

Prof. Christopher J. White: The best medical therapy right now is aspirin.  It has not been clear whether it should be 81mg or 325mg， but the consensus expert opinion right now is aspirin.  There are other studies now that are variable and add clopidogrel， but there is an excess of bleeding that has been noted in some of those patients.  That is certainly a questionable trade-off.  There is another group that believes that the addition of dipyridamol to aspirin， as a combination therapy， has some benefit.  Again， within clinical choice you could choose any of those three therapies tailored to your patient but I think the conservative therapy would be one tablet of aspirin a day. 
Prof. Christopher J. White:  目前最好的药物治疗是阿司匹林。虽然目前关于使用剂量是81mg还是325mg还未明确，但专家一致建议使用阿司匹林。现在还有一些研究认为可以添加clavix或氯吡格雷抗血小板聚集，但对于这些患者需要注意出血的问题。这是一个需要权衡考虑的问题。还有一些研究认为，可以在使用阿司匹林的基础上加用潘生丁，两者联合使用有一定好处。在临床上需要根据病人的个体情况，从上述三个方案中选择合适的治疗方法，但我觉得最直接、保守的治疗方法是每天服用阿司匹林，一次一片。

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