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灿烂的阳光，悠长的石滩，宽广的蓝色海岸以及古罗马帝国时代遗留的古老街道，使环绕地中海的法国尼斯小城充满了迷人的气息。第17届欧洲卒中大会于2008年5月在尼斯举行，来自全世界各地的约3500名代表出席了本次会议，共同探讨和分享了最新最权威的学术成果。会议收到了包括从基础到临床的1000多篇摘要投稿， 短暂性脑缺血发作（TIA）定义更新、系列大型临床研究结果的公布以及卒中干细胞治疗等热点发言受到广泛关注。本报特派记者前往尼斯，实时跟踪报道了本次会议，更多精彩敬请关注《国际循环网》第17届欧洲卒中大会专题报道http://www.icirculation.com/special/Euro-stroke。
Michael G. Hennerici，德国海德堡大学，本届欧洲卒中大会策划主席及学术委员会委员
《INTERNATIONAL CIRCULATION》: As a chairman of the programme committee，could you please give us a brief introduction about the 17th European Stroke Conference (ESC)?
您作为本次大会的主席之一，能否为我们介绍一下此次欧洲卒中会议的概况？
Dr. Hennerici: It is our largest stroke conference ever in the world， with more than 3500 people attending from more than 80 countries. We had a series of more than 1000 abstract submissions from research groups both experimental and clinical. And the meeting covers all research ranges from bench to bedside which is nowadays called translational stroke research.
本次大会是迄今为止全球规模最大的卒中会议，共有来自80多个国家的3500多名代表参加了本次大会。大会共收到包括基础和临床研究的约1000多篇摘要投稿。会议内容涵盖了从基础到临床的内容，也就是目前所说的转化型研究。
《INTERNATIONAL CIRCULATION》: For patients with ischemic stroke， four antiplatelet agents have been shown to reduce the risk of recurrent ischemic stroke and are currently approved by the FDA for this indication. What are the factors that may guide the decision to select a specific antiplatelet agent to initiate first after ischemic stroke?
目前已经有四种抗血小板药物获得了FDA的批准，可以用于缺血性卒中患者的二级预防，这些药物有助于降低缺血性卒中复发的风险。那么，在缺血性卒中后选择某一种特定药物开始抗血小板治疗时，需要考虑哪些因素？
Dr. Hennerici: There is a presentation at the 17th Euro-stroke， a very important study conducted in more than 20 000 patients，which shows that，beyond aspirin， the oldest drug to prevent stroke， two others antiplatelet agents are of similar value， one is clopidogrel， and the other one is dipyridamole in the extended preparation together with low-dose aspirin: both are significantly better than aspirin alone. They should now become first choice after stroke.
在此次Euro-stroke大会上有一个讲座是关于一项观察了20 000多例患者的非常重要的研究。该研究结果显示，阿司匹林仍然是预防卒中的最经典药物。但是，还有其他两种药物同样有效。一种是氯吡格雷，另外一种是双嘧达莫缓释剂和小剂量阿司匹林的合剂。这两种治疗药物都比阿司匹林单药治疗更为有效，应当作为卒中后治疗的首选用药。
《INTERNATIONAL CIRCULATION》: Randomized trials have addressed the use of oral anticoagulants to prevent recurrent stroke among patients with noncardioembolic stroke， including strokes caused by large-artery intracranial or extracranial atherostenosis， small penetrating artery disease， and cryptogenic infarcts. Should we still choose antiplatelets over anticoagulants in the setting of noncardioembolic stroke?
一些随机临床试验提示，对于非心源栓塞性卒中患者（包括颅内外大动脉粥样硬化性卒中、腔隙性脑梗死和隐匿性脑梗死），口服抗凝剂有助于预防卒中复发。目前的观点是，对于非心源栓塞性卒中患者应给予抗血小板药物而不是抗凝剂治疗，我们是否应当继续坚持这一看法？
Dr. Hennerici：The question is by far too complex to be answered in a few words. To make it simple， all stroke patients have to be treated for secondary prevention. Some patients have to be treated specifically. Those with significant carotid artery disease have to be treated with carotid endarterectomy or stenting as shown in this meeting - provided the procedures are performed by real experts in that field and have a personal low risk profile. And there are some other patients who suffer from non-valvular fibrillation as the source of cardiogenic stroke， who are candidates for anticoagulation， all the others should be treated with antiplatelet agents.
这个问题很难用简单的几句话概括完全。但是总的来说，所有卒中患者都应当进行二级预防。其中某些患者需要给予特殊的治疗手段。从本次会议的发言中我们可以看到，颈动脉显著病变的患者需要实施颈动脉内膜切除术或是置入支架，但要保证该领域的技术能够达到要求，同时患者本身个体的风险较低。此外，非动脉性心房颤动来源的心源性栓塞患者给予抗凝剂的同时也需要给予房颤治疗药物。