阿司匹林抵抗与脑梗死急性期梗死进展的相关性研究  

Correlation between Aspirin Resistance and Neurological Deterioration in Acute Cerebral Infarction

作　　者：曾文双[1] 林志坚[2] 张季声[2] 

机构地区：[1]香港大学深圳医院神经内科 [2]北京大学深圳医院神经内科,广东深圳518000

出　　处：《实用临床医学（江西）》2016年第5期1-3,14,F0004,共5页Practical Clinical Medicine

基　　金：深圳市2012年基础研究计划项目(JCYJ20120830161804255)

摘　　要：目的：探讨急性脑梗死患者阿司匹林抵抗（aspirin resistance，AR）与急性期梗死进展的相关性。方法对92例急性脑梗死患者于入院第1天行头颅 MRI 检查，并予阿司匹林300 mg负荷剂量口服，服药3h后采用全血阻抗法检测血小板聚集率。根据检测结果将92例患者分为 AR 组和阿司匹林敏感（AS）组，7d后复查头颅 MRI。对2组脑梗死急性期梗死进展的发生率进行比较；采用多元 Logistic 回归分析脑梗死急性期梗死进展的危险因素。结果AR 组31例（33．7％），AS 组61例（66.3％）。AR 组 NIHSS 评分、急性期梗死进展发生率明显高于 AS 组[7．0（9．0）比5．0（6．0），P ＝0．041；32．3％比18．0％，P ＝0．026]。多元 Logistic 逐步回归分析示：AR（OR 3．082，95％CI 1．072-8．954，P ＝0．028）、NIHSS 评分（OR 1．212，95％CI 1．014-1．435，P ＝0．032）及年龄（OR 1．049，95％CI 1．003-1．102，P＝0．035）是急性期脑梗死进展的独立危险因素。结论AR作为脑梗死急性期梗死进展的独立危险因素，在急性脑梗死的预后判断和二级预防策略的选择上具有重要价值。Objective To investigate the correlation between aspirin resistance（AR）and neurological deterioration in patients with acute cerebral infarction.Methods A total of 92 patients with acute cerebral infarction received cranial MRI scan and oral administration of 300 mg loading dose of aspirin on the first day after admission.Platelet aggregation was detected by whole blood impedance aggregometry 3 hours after aspirin loading.According to the results,these patients were divided into AR group and aspirin-sensitive（AS）group.Cranial MRI scan was repeated 7 days after admission.The incidence of neurological deterioration was compared between the two groups,and its risk factors were analyzed using multivariate logistic regression analysis.Results Among the 92 patients,31（33.7%）were resistant to aspirin,and 61 （66.3%）were sensitive to aspirin.Compared with AS group,NIHSS score and incidence of neurological deterioration significantly increased in AR group（7.0（9.0）vs 5.0（6.0）,P=0.041 and 32.3% vs 18.0%,P =0.026, respectively）.Multivariate logistic regression analysis revealed that AR（OR 3.082,95%CI 1.072-8.954,P =0.028）,NIHSS score（OR 1.212,95%CI 1.014-1.435,P=0.032）,and age（OR 1.049,95%CI 1.003-1.102,P=0.035）were the independent risk factors for neurological deterioration＆amp;nbsp;in patients with acute cerebral infarction.Conclusion As an independent risk factor for neurological deterioration,AR is of great value in the prediction of prognosis and the selection of secondary prevention strategies in patients with acute cerebral infarction.

关 键 词：阿司匹林抵抗 脑梗死 梗死进展 血小板聚集 

分 类 号：R743.3[医药卫生—神经病学与精神病学]