缺血性脑卒中复发与阿司匹林抵抗的相关性研究  

Recurrence of ischemic stroke associated with aspirin resistance:a correlation study

作　　者：李钊[1] 董梅[2] 李世平[2] 赵仕琪[2] 槐瑞雪 史肖鹤 李震中[2] 

机构地区：[1]河北医科大学第三医院神经外科,河北石家庄050051 [2]河北医科大学第二医院神经内科神经病学河北省重点实验室,河北石家庄050000

出　　处：《中风与神经疾病杂志》2017年第6期497-499,共3页Journal of Apoplexy and Nervous Diseases

基　　金：河北省科技厅项目(No.15967727D)

摘　　要：目的观察缺血性脑梗死初发以及复发患者阿司匹林(ASP)疗效,探讨缺血性脑梗死复发与阿司匹林抵抗(AR)的关系,并对复发患者的危险因素进行相关性分析。方法采用回顾性研究方法,将急性缺血性脑梗死患者分为初发组和复发组,复发组入院后即行血栓弹力图(TEG)检测,初发组规律服用ASP后1 m进行TEG检测,比较初发组及复发组AR发生率。并对患者生化指标、TOAST分型及危险因素等进行Logistic回归分析,探讨缺血性脑梗死复发的临床相关因素。结果初发组AR发生率为28.57%;复发组AR发生率为56.76%。复发组AR明显高于初发组(P<0.01)。糖尿病、冠心病在复发组出现率高(P<0.05);年龄、性别、吸烟、饮酒、高血压、高脂血症、动脉粥样硬化型、BMI、TG、CHOL、LDL、HDL、HCY及hs-CRP的水平两组差异无显著性(P>0.05)。对P<0.1危险因素的Logistic回归分析示AR、糖尿病与缺血性脑梗死复发明显相关。结论 AR能显著增加缺血性脑梗死复发风险;糖尿病增加缺血性脑梗死复发风险。Objective To investigate aspirin efficacy in ischemic cerebral infarction of primary attack and recurrent patients ,to discuss the relationship between recurrence of ischemic cerebral infarction and aspirin resistance. And then analysis the risk factors of recurrent ischemic cerebral infarction patients. Methods By retrospective study, We enrolled patients with acute ,ischemic cerebral infarction, according to the number of clinical onset, all patients can be divided into primary group and recurrent group. All eases were detected aspirin efficacy through thromboelastography（TEG） after regular use of aspirin at least 1 month. Compare the aspirin. The risk factors were analyzed by Logistic regression analysis, then discussed the correlation between risk factors and recurrent ischemic cerebral infarction. Results The incidence of AR in primary group was 28.57%. The incidence of AR in recurrence group was 56.76%. The incidence of AR in recurrence group was significantly higher than that in primary group （P 〈0.01 ）. Diabetes mellitus and coronary heart disease （CHD） in recurrence group were higher by statistically significant （ P 〈 0.05 ）. The risk factors of P 〈 0. 1 were selected by logistic regression analysis showed that recurrence were significantly correlated with AR and diabetes. Conclusion AR can remarkably increase the recurrent risk of ischemic cerebral infarction. Diabetes may increase the recurrent risk ischemic cerebral infarction.

关 键 词：阿司匹林抵抗 血栓弹力图 缺血性脑梗死 复发风险 

分 类 号：R743.3[医药卫生—神经病学与精神病学]