阿司匹林抵抗在脑梗塞复发中的现状调查  

Aspirin Resistance in Recurrent Cerebral Infarction Investigation

作　　者：陆丽霞[1] 吴卫文[1] 黄屏娟[1] 顾青[1] 

机构地区：[1]上海市中山医院青浦分院,上海201700

出　　处：《医学信息》2012年第8期105-106,共2页Journal of Medical Information

摘　　要：目的调查脑梗塞患者中发生阿司匹林抵抗（aspirinresistance，AI〈）的情况，分析阿司匹林抵抗在脑梗塞复发中的作用，探讨可能机制。方法收集1a内初发脑梗塞患者共258例，服用阿司匹林100mg／d，1a后进行随访调查，将患者分为复发组和非复发组，复发脑梗组患者于发生再次脑梗时行空腹血检查，非复发脑梗组患者于1a后行空腹血检查，分别用二磷酸腺苷（ADP）、花生四烯酸诱导做血小板聚集试验（PAgT），检测最大血小板聚集率（MAR）。结果复发组患者中AR发生率18．75％（9／48），阿司匹林半敏感（spirinsemisensitive，ASR）者占64．58％（31／48），非复发组患者申AK发生率7．57％（14／185），阿司匹林半敏感（ASR）4e占26．49％（49／185），两者比较其P〈0．001存在统计学差异．而发生AR、ASR的患者中均以年长、女性、糖尿病、高血脂患者居多。结论AR在脑梗塞患者中确实存在，并且更易导致脑梗塞复发，阿司匹林用于抗血小板治疗及预防动脉硬化事件的药物，患者若有AR存在，应及时换用其它安全有效的抗血小板制剂，因阿司匹林需要长期应用．故预测AR及抗血小板治疗个体化．将是来来抗血小板治疗的研究方向．Objective To evaluate the prevalence of aspirin resistance in patients with cerebral infarction, to analyse the effect of aspirin resistance in recurrent cerebral infarction and to explore the possible mechanisms. Methods Collect 258 patients with primary cerebral infarction in one year, all of them received 100mg/d of aspirin, Aspirin resistance was analysed by examination of blood platelet aggregation induced by adenosine diphosphate （AD） and arachidonic acid （AA）.Results the incidence of AR in recurrent group was 18.34%, aspirin semi sensitive （ASR） accounted for 80.51%, the incidence of AR in non recurrent group was 7.21%, aspirin semi sensitive （ASR） was 26.52%, there was significant difference（P〈0.00l）, and the majority of patients Which with AR ASR are older, female, diabetes mellitus. Conclusion AR in cerebral infarction patients do exist, and are more likely to result in recurrent cerebral infarction, The safe ahernative antiplatelet agent for long administration should be used if aspirin resistance appears, prediction of AR and individualization of antiplatelet therapy would be an emerging direction of antiplatelet therapy.

关 键 词：脑梗塞 阿司匹林抵抗 血小板聚集 

分 类 号：R971.1[医药卫生—药品]