?????? ?.?.
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E-mail: korzunai@mail.ru
? ????? ????????? ???????? ?????????? ?????? ???????????? ???????? ? ?????????? ??????????????? ?????????????? (? ????????????? ?? ??????? ???????? ??????: ????? ? ????????-?????????? ??????????, ???????) ???? ???????? ????-?????? ???????????? ?? ???????????? ????????.
??? ????-??????? ???? ??????????? ????? ? ???? ??????????? ????? ??????: PubMed ( http://www.ncbi.nlm.nih.gov/pubmed/ ) ? MedLine ( http://www.medscape.com/ ). ??? ?????? ?????????????? ???????? ?????: “trial” ? ?????????? ? “stroke” ? “meta-analysis” ? ??? ?? ??????????. ????? ????????????? ????? ???? ????????? ?????????? ???? ??? ?????? ? 1960 ?? ???? 2003 ????. ??? ?????????? ???? ??????????? ???????????? ? ???????? ????????? ??????? ????????? ????.
????????????? ? ??????? ? ???????????? ????????
???????????? ????????:
AITIA, 1978?, 319 ?-?, ???????? ????? ???????? ? ?????? ?? 30% (Stroke 8, 301 – 318, 1978; Stroke 9, 309 – 318, 197
,CCS, 1978?, 863 ?-?, ???????? ????? ???????? ? ?????? ?? 31% (N Engl J Med 299, 53 – 59, 197
,AICLA, 1983?, 808 ?-?, ???????? ????? ???????? ? ?????? ?? 29% (Stroke 14, 5 – 14, 1983; Presse Med 12, 3049 – 57, 1983),
SPAF I, 1991?, 1 200 ?-?, ???????? ????? ???????? ? ?????? ?? 40% (N Engl J Med 1990;322:863-8; Circulation 1991;84:527-39),
SALT, 1991?, 1 360 ?-?, ???????? ?????????? ?? 18% (Lancet 1991;338:1345-9),
UK-TIA, 1991?, 2 435 ?-?, ???????? ????? ?? 18% (J Neurol Neurosurg Psychiatry 1991;54:1044-54; Gut 1995;37:509-11),
ACAS, 1995?, 1 662 ?-?, ???????? ????? ?? 53% (Stroke 1989;20:844-9; JAMA 1995;273:1421-
,ESPS1, 1998?, 1 306 ?-?, ???????? ????? ???????? ? ?????? ?? 33% (J Neurol Sci 1998;154:200-4),
ACE, 1999?, 2 849 ?-?, ??????????? ???????? ??????????? (Lancet 1999;353:2179-84),
ESPS2, 1999?, 6 602 ?-?, ??????? ????? ???????????? (Acta Neurol Scand 1999;99:54-60; Neurology 1999;53:825-9),
???????????? ????????????:
CAPRIE, 1996?, 19 185 ?-?, ???????????? ????? ???????? ?? 8,7% (Lancet 1996;348:1329–39; Drug Safety 1999;4:325–35),
??????????? ?????????????? ? ??????? ? ???????????? ????????
???????????? ?????????:
EAFT, 1993?, 1 007 ?-?, ???????? ????? ???????? (Lancet 1993;342:1255-62; N Engl J Med 1995;333:5-10),
PATAF, 1998?, 729 ?-?, ??????????? ???????? ??????????? (J Am Coll Cardiol 1998;31 Suppl A:344A),
SPINAF, 1992?, 571 ?-?, ???????? ????? ???????? - 79% (p<0,002) (N Engl J Med 1992;327:1406-12),
SPIRIT, 1997?, 1 243 ?-?, ??????????? ???????? ??-?? ???????????? ? ?????? ????????? (??? 3,0 – 4,4) (Stroke 1997;28:231),
TPT, 1997?, 5 085 ?-?, ??????????? ???????? ??????????? (Am J Cardiol 1990;65 Suppl C:7C-11C; J Neurol Neurosurg Psychiatry 1997;62:269-72; Lancet 1998;351:233-41),
WARSS, 1997?, 1 920 ?-?, ??????????? ???????? ??????????? (Cerebrovasc Dis 1997;7:100-12),
BAATAF, 1990?, 420 ?-?, ???????? ????? ???????? - 82% (p<0,002) (N Engl J Med 1990;323:1505-11; Am Heart J 1992;124:1567-73; Stroke 1993;24:1360-5),
AFASAK - ???????? ????? ???????? ?? 58% (p<0,03) (Lancet 1989;1:175-9; J Cardiovasc Electrophysiol 1998;9 Suppl:S86-96),
CAFA, 1991?, 378 ?-?, ???????????? ??? ??????????????? - 16%, ??? ??????? - 9%, ???????? ????? ???????? - 42% (p>0,2) (J Am Coll Cardiol 1991;18:349-55; Can Med Assoc J 1996;154:1669-74),
SPAF, 1990?, ???????? ????? ????????, ???????? ????? ???????? - 67% (N Engl J Med 1990;322:863-8; Circulation 1991;84:527-39),
??????????? ??? (????????? ??????????? ??????????????? ???????) ??? ???????????? ????????????? ??? ?????? ????????? - 2,0 – 3,0
?????? ?????????????? ? ??????? ? ???????????? ????????
???????????? ????????:
IST, 1997?, 19 435 ?-?, ??????? ?? ???????? ?? ???????? (Lancet 1997;349:1569-81),
???????????? ????????????????? ?????????:
TOAST, 1998, 1 281 ?-?, ?????? ?????????????? ???????????? ? ?????? ??????? (JAMA 1998;279:1265-72),
??????????? ? ??????? ? ???????????? ????????
???????????? ?????????????:
ASK, 1996?, 340 ?-?, ??????????? ???????? ??-?? ??????????? (JAMA 1996;267:961-6; Stroke 1996;27:1524-9),
MAST-E, 1994?, 300 ?-?, ??????????? ???????? ??-?? ??????????? (Clin Trials Meta-Analysis 1993;28:329-44; Lancet 1994;345:57; N Engl J Med 1996;335:145-50),
MAST-I, 1995?, 622 ?-?, ??????????? ???????? ??-?? ??????????? (Lancet 1995;346:1509-14; Lancet 1995;346:1515),
???????????? ??????????:
ECASS, 1995?, 620 ?-?, ???????? ? ?????????? ???, ??????????????? ?????? ????? (JAMA 1995;274:1017-25; JAMA 1995;274:1058-9),
ECASS II, 1998?, 800 ?-?, ? ?????? 7 ???? ???? ??????????? ?? ????????????, ???????? ? ????? ?????????? ???, ??????????????? ?????? ????? (Lancet 1998;352:1245-51),
???????? ? ??????? ? ???????????? ????????
???????????? ??????????????? ?????? ???????:
NASCET, 1991?, 1 212 ?-?, ??????????? ???????? ??-?? ????? ??????????? ???????? ????? ????????? (Stroke 1991;22:711-20; N Engl J Med 1991;325:445-53; J Neurosurg 1995;83:778-82),
??????? ? ??????? ? ???????????? ????????
???????????? ????????????:
SSSS, 1995?, 4 444 ?-?, ???????? ?????????? ?? 28%, ???????? ????? ???????? ?? 30% (Am J Cardiol 1993;71:393-400; Lancet 1994;344:1383-9; Am J Cardiol 1995;76:64C-8C; Lancet 1995;345:1274-5; Arch Intern Med 1996;156:2085-92; PharmacoEconomics 1996;9:101-5; Eur Heart J 1996;17:1001-7),
HPS, 2001?, 20 536 ?-?, ??????????? ???????? ????? ???????? ?? 24% (Eur Heart J 1999;20:725-41; Ann Med Interne (Paris) 2001 Apr;152(3):188-93; Am J Cardiol 2002 Mar 7;89(5A):50C-57C; Int J Clin Pract. 2002 Jan-Feb;56(1):53-6),
???????????? ????????????:
CARE, 1999?, 4 159 ?-?, ???????? ????? ???????? (Am J Cardiol 1991; 68:1436-46; N Engl J Med 1996;335:1001-9; Circulation 1999;99:216-23),
????-??????? ???????? ??? ???????????? ????????:
- Circulation. 1995 Nov 1;92(9):2419-25: 1 981 ?-?, ???????? ????? ???? ????????? ?? 62% ? ?????? ????????,
- JAMA 1997 Jul 23-30;278(4):313-21: 29 000 ?-?, ?????????? ???????? ??????? ???? ???????? ?? 29% (~ 1/3 ?-?),
- Arch Intern Med. 1999 Aug 9-23;159(15):1793-802: 21 303 ?-?, ? ?????? ???????? ???????? ????? ?????????? ???????? – ?? 23%, ?? ???????????? ???????? – ?? 31%,
- J Gen Intern Med. 1999 Dec;14(12):763-74: 19 921 ?-?, ??? ?????? ???????? ???????? ????? ???? ????????? – ?? 30% (?=0,0005), ? ?? ????????? ????????? – ?? 36% (?=0,00001),
- Cerebrovasc Dis. 2000 Mar-Apr;10(2):85-92: 80 000 ?-?, ??????????? ???????? ????? ???????? ?? 23% ???????? ?????? ? ?????? ?-?, ??????????? ???????,
- Orv Hetil. 2000 Jul 2;141(27):1501-5: 450 000 ?-?, ?????????? ???????? ??????? ???? ???????? – ?? 10 – 31%,
- Ann Med Interne (Paris) 2001 Apr;152(3):188-93: 32 000 ?-?, ???? ???????? ???????? ? ?????? ??????? ????????? ?? 25% ??? ????????? ???????????? ? ?? 15% ??? ????????? ????????????, ???????? ????? ???????? ???? ??????? ????? ???????? ? ?????? ???????????? (?? 29%, ?=0,049), ??? ? ?????? ???????????? (?? 21%, ?=0,003
- Circulation 2001 Jan 23;103(3):387-92: 19 768 ?-?, 22% ???????? ???? ????????? (7% ?????? 35%, ?=0,01), 25% ???????? ??????????? ????????? (10% ?????? 38%) ? 23% ???????? ????????????????? ????????? (6% ?????? 37%),
- Arch Intern Med. 2003;163:669-76: 83 161 ?-?, ???????????? ???????? ????? ???????? (?? 26%) ?????????? ?? ???? ????? ????????,
- BMJ. 2003 Jun 28;326(7404):1423: ? ?????????? ??????? ????????? ???????? ???? ??????????? ?? 1,0 ?????/? ????????? ? ???????? ????? ???? ????????? ?? 10%, ? ?? 1,8 ?????/? – ?? 17%,
- Pharmacotherapy. 2003 Jun;23(6):726-30: ?????????? ???????? ??????? ???? ??????????? ??????????? ??????? ?? 57%,
- BMJ. 2003 Jun 28;326(7404):1419: ?????? (40 ??/??? ???????????? ??? 10 ??/??? ?????????????), ??? ?????????? ???????? ???????? ????????? (????????? ????????, ????-???????? ? ????????? ???), ?????? ? ???????? ??????????? ????, 0,8 ??/??? ???????? ??????? ? 75 ??/??? ???????? - ????? ?????????? ??????? ???? ???????? – ?? 80%,
?????????? ??? ? ??????? ? ???????????? ????????
???????????? ?????????:
HOPE, 2000?, 9 541 ?-?, ???????? ?????????? ?? 22%, ???????? ????? ???????? ?? 32%, ???????? ????? ?????????? ???????? ?? 62% (Can J Cardiol 1996;12:127-37; N Engl J Med 2000;342:145-53; N Engl J Med 2000;342:154-60),
SECURE, 1999?, 732 ?-?, ??????????? ?????????? ??????? ???????? (?.?. ?????????? ????????) ?????? ??????? (Am J Cardiol 1996;78:914-9; Circulation 1999;100 Suppl I:I-185),
???????????? ????????????:
PROGRESS, 2001?, 6 105 ?-?, ???????? ????? ?????????? ???????? ?? 28%, ?? ?????? ? ?????????? ? ???????????, ??????????? ????????????? ???? ???????? ?????????? ?? ??????? (J Hypertens 1995;13:1869–73; Lancet 2001;358:1033–41),
??????????? ?????????? 1 ???? ???????????? II ? ???????????? ????????
???????????? ?????????:
–LIFE, 2003?., 9193 ?-?, ???????? ????? ???????? ?? 25% ? ?????? ????????? ?? ????????? ? ?????????? (Circulation. 2003 Aug 12;108(6):684-90, Clin Ther. 2003 Apr;25(4):1186-99, Curr Neurol Neurosci Rep. 2003 Jan;3(1):46-51),
???????????? ????????????:
–SCOPE, 2003 ?., 4964 ?-?, ???????? ????? ???????? ?? 28% (J Hypertens. 2003 May;21(5):875-86),
???????????? ?????????? ???????????? ?? ??????? ???????? ?????? ?????????:
???????????? PASS (n=927): ??????????? ? ??????????????? ????? ? ????? ??????? (????????? ? ???????) – ?????????? (Stroke 1997; 28: 2347-52; CNS Drugs 1998; 9 Suppl 1: 41-9).
?????????? ???????????? ???????????? ????-??????? ???????? ?????? ?????????? ????????? ????? ??????? ? ?????????? ??????????????? ??????????????.
????? ??????? ?????? ?? ????????? ????????, ???????? ????? ?????????? ???? ???????????? ?????????? ???? ??????:
???????????? ??????????? ? ??????????????? ????????????? «?????????».???????? ?????????? ??????????? ?????? ???????????? ?? «???????» ???????? ?????? ???????????
?????? N Engl J Med 315, 1241, 1986
Neurology 43 S64, 1993
N. Engl. J. Med. 327: 1253, 1992 ?????????? ????????????? ??? ??????? FDA ?????? ??? ??????? ??????? ???????????
??-????????? ??????? / ????????????????? J Am Geriatr Soc 35, 219, 1987;
J Am Geriatr Soc 32, 584, 1984 ????????? ?????? ???
?????????? (???????) Cur Ther Res 48, 597, 1990 ????????? ?????? ???
2-????-??????????? (?????? ??????????): ?????????, ???????????, ??????????, ???????????, ???????????? Neurology 43, 301, 1993;
Arch Gerontol Geriatr 16, 149, 1993;
Stroke 1997; 28: 2347-52;
CNS Drugs 1998; 9 Suppl 1: 41-9 ????????????? ??????????? ???????????? PASS (n=927): ??????????? ? ??????????????? ????? ? ????? ??????? (????????? ? ???????) - ??????????
?????????????????? ??-????????? (?????????) Ann Neurol 18, 705, 1985
N Engl J Med, 308: 619, 1983 ?????????????? ?????? ??? ??????? FDA ?????? ??? ????????????????? ??????????????
??????????????? (??????????????, ???????) Stroke 19, 716, 1988 ????????????? ??? ???????? ?? ????????, ?????? ?????????? ? ??????? ??? ??????? FDA ?????? ??? ??????? ????????? ?????????????? ???????
????????? ??????? Gingko biloba Munch Med Wochenschr 133, S23, 1991 ????????? ?????? ??? 8 ???????????? ? ???????????????? ?? ??????????? ???????? ??????,
1 ???????????? ? ?????????????? ????????????
???????????? ????????? ????? ???????? (????????????) Jpn Pharmacol Ther 20, 4, 1992 ????????? ?? ?????????? ??????* ??? ?? ??????? FDA, ????????? ?????????? ?? ???????????????? (?.?. ?????????? ??????) , ??????????? ?????????? ? ???????????????
??????????? ??????????? (?????????, ?????????, ?????????) Neuropsycho-biology 1992; 26(1-2): 65-70
Pharmaco-psychiatry 1986 Sep; 19(5): 378-85
Pharma-therapeutica 1980; 2(5): 317-22 ??????? ????????? ?? ?????? ?? ????????? ???
?????????? ???-? (????????) Am J Psychiatry 150, 321, 1993 ????????? ?? ?????????? ??????* ???
???? ?????-?????????????? ??????? (?????????, ????????) ??????? ?.?., ?????, ???, 1992
In Medline – ?????????? ??????????? ????????? ?? ?????????? ??????* ???
????????? ?????? ???????? (??????????, ????????) Cochrane Database Syst Rev 2000;(2): CD000480
Int Clin Psychopharmacol 1991 Spring; 6(1): 31-43 ????????????? ??????????? ??? ?? ??????? FDA, ????? ?? ??????? ? ?????? ??-?? ????? ??????????????? ( http://www.lenta.ru )
???????????? (???????????? ???????) ??????? ?.?., ?????, ???, 1992
In Medline – ?????????? ??????????? ????????? ?? ?????????? ??????* ???
???? ???????????????? ??????? (????????) ??????? ?.?., ?????, ???, 1992
In Medline – ?????????? ??????????? ????????? ?? ?????????? ??????* ???
??????????? ?????????????? (?????? ???????????, ?????????) Ann N Y Acad Sci 1994 Jun 30; 717: 253-69
J Int Med Res 1991 Jul-Aug;19(4):330-41 ????????? ?? ?????????? ??????* ???
?????????????? (??????, ??????) ?????????? ?.?., ???-? 12, 1993
In Medline – ?????????? ??????????? ????????? ?? ?????????? ??????* ??? ????? ????????? ? ????????, ?????????????? ??? ????????? ???
?????????? (????????) Z Hautkr 1987 Feb 15;62(4):325-9 ????????? ?? ?????????? ??????* ???
??????? ??????? ?.?., ?????, ???, 1992
In Medline – ?????????? ??????????? ????????????? ??????????? ??? ??????? ?????????????? ? «???????????» ??????????, ???????????? ?????? ? ??????
*??? ?? ?????????? ???????? ??????????????? ?????????? ??????????? ???????????? ???????? ?????????.
??????:
?? ??????????? ???? ??????????? ????????? ???????????? ???????? ????????: ???????, ????????????? ??????? (??????????????? ?????? ???????), ??????????? ??? ???????????, ????????, ???????? ??? ???????????, ???????? (??????????? ??????????, ??????? ???????? ??????).
???????? ?? ???????? ?????????? ???????????? ????????.
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