目的研究阿司匹林对低踝臂指数(ankle brachial index,ABI)人群卒中一级预防的作用。方法筛查健康体检人群中低踝臂指数者(ABI≤0.9),随机分为阿司匹林治疗组和未接受阿司匹林治疗的对照组,随访观察18个月,比较两组人群缺血性卒中发病率的差异。结果 1090例符合入组标准的低踝臂指数人群纳入本研究,496例接受阿司匹林治疗,与对照组相比,治疗组的年龄[(60±8.9)岁比(59±9.1)岁,P=0.321]、性别(男性:58.1%比59.5%,P=0.57)差异无统计学意义。随访18个月,治疗组首发脑梗死患者11例/457例(2.4%),与对照组(16/563例,2.8%)相比差异无统计学意义(P=0.667);两组患者中各有2例患者出现症状性颅内出血;治疗组主要终点事件和次要终点事件中缺血性血管事件的总体发病率(5.7%比9.0%,P=0.044)和短暂性脑缺血发作的发病率(1.3%比3.2%,P=0.048)显著低于对照组。结论低踝臂指数人群进行阿司匹林一级预防并不能有效预防缺血性卒中。 Objective To study the effect of aspirin on primary prevention of stroke in ankle brachial index (ABI). Methods The ABI≤0.9 was screened in healthy people, and randomly divided into aspirin group and non-aspirin control group. The follow-up period was 18 months. The incidence of ischemic stroke was compared between the two groups difference. Results A total of 1090 low-ankle-brachial index patients who met the inclusion criteria were enrolled in this study and 496 asymptomatic aspirin-treated patients. The age of patients in the treatment group (60 ± 8.9 years vs 59 ± 9.1 years, P = 0.321]. There was no significant difference in gender (male: 58.1% vs 59.5%, P = 0.57). After 18 months of follow-up, 11 cases / 457 cases (2.4%) in the treatment group had no significant difference compared with the control group (16/563 cases, 2.8%) (P = 0.667) Symptomatic intracranial hemorrhage occurred in 2 patients each; the overall incidence of ischemic vascular events (5.7% vs 9.0%, P = 0.044) and transient ischemic attack in the primary and secondary endpoints of the treatment group Incidence (1.3% vs 3.2%, P = 0.048) was significantly lower than in the control group. Conclusion Aspirin can not effectively prevent ischemic stroke in primary ankle-brachial index population.