急性脑梗死患者氯吡格雷抵抗的相关因素研究  

Relevent factors for clopidogrel resistance in patients with acute cerebral infarction

作　　者：吴金龙[1] 钟池[2] 王磊[2] 李文[2] 王绍博[2] Wu Jinlong Zhong Chi Wang Lei et al(Department of Neurology , Wei fang Medical University , Wei fang 261053)

机构地区：[1]山东省潍坊市潍坊医学院神经病学教研室,261053 [2]潍坊医学院附属潍坊市人民医院神经内科

出　　处：《卒中与神经疾病》2016年第6期395-398,共4页Stroke and Nervous Diseases

摘　　要：目的探讨急性脑梗死患者氯吡格雷抵抗(clopidogrel resisitance,CR)的相关因素。方法收集急性脑梗死患者100例,入院后连续口服氯吡格雷7 d后空腹抽取肘静脉血,用血栓弹力图(thromboelastograms,TEG)测得二磷酸腺苷(adenosine diphosphate,ADP)受体途径诱导的血小板抑制率,将患者分为氯吡格雷抵抗组(CR)和氯吡格雷敏感组(clopidogrel sensitivity,CS);根据2组患者的临床检测水平和Logistic回归分析引起CR的因素。结果 31例患者出现氯吡格雷抵抗,发生率为31%。单因素分析发现并发2型糖尿病、LDL-C水平、空腹血糖水平(FPG)差异明显(P<0.05)。多因素Logistic回归分析发现,2型糖尿病(OR=13.198,P<0.05)、LDL-C水平(OR=0.349,P<0.05)是引起CR的独立危险因素。结论部分急性脑梗死患者会出现氯吡格雷抵抗,2型糖尿病、LDL-C水平是其独立危险因素。Objective To explore the relevent factors for clopidogrel resistance in patients with acute cerebral infarction. Methods One hundred patients with acute ischemic stroke were recruited. Whole bloodsamples were collected after clopidogrel was administered for 7 days, the inhibitory rates of ADP receptor pathway in platelets were detected by TEG. Patients were divided into two groups： CR group and CS group. Clinical data in the two groups were compared and logistic regression analysis was performed for the factors of CR. Results There were 31 cases with CR and the occurrence rata of CR was 31%, Single factor analysis showed that the type 2 diabetes mellitus, LDL-C levels , FPG levels were obviously different between two groups （P〈0. 05）, Logistic regression analysis revealed that type 2 diabetes mellitus （OR = 13. 198,P〈0. 05） and the LDL-C level （OR = 0. 349,P〈0. 05） were independent risk factors of CR. Conclusion CR may occur in some patients with acute cerebral infarction, and type 2 diabetes mellitus, elevated LDL-C level were inde- pendent risk factors. Cerebrovascular adverse events are apt to recur in these patients.

关 键 词：急性脑梗死 氯吡格雷抵抗 血栓弹力图(TEG) 

分 类 号：R743.3[医药卫生—神经病学与精神病学]