缺血性脑卒中病人血瘀证与抗血小板药物抵抗的相关性研究  

Correlation between Blood Stasis Syndrome and Anti Platelet Drug Resistance in Patients with Ischemic Stroke

作　　者：张萃艺 黄燕[2] 马健 倪浩斌 蔡汉潮 

机构地区：[1]广州中医药大学深圳医院(福田),广东深圳518034 [2]广东省中医院

出　　处：《中西医结合心脑血管病杂志》2018年第4期472-474,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：2016年度深圳市福田区卫生公益性科研项目(No.FTWS20160037)

摘　　要：目的探讨缺血性脑卒中病人血瘀证与抗血小板药物抵抗的相关性。方法将126例缺血性脑卒中病人参照血瘀证诊断标准分为非血瘀证组(39例)与血瘀证组(87例),所有病人双抗治疗大于1周后,采用血栓弹力图检测花生四烯酸(AA)途径及二磷酸腺苷(ADP)途径诱导的血小板抑制率,观察比较两组病人的血小板抑制率及抑制效应。结果血瘀证组双抗治疗后血小板ADP受体途径抑制率较非血瘀证组降低,氯吡格雷抵抗发生率较非血瘀证组升高(P<0.05)。结论对于缺血性脑卒中尤其是合并血瘀证的病人,口服抗血小板药物治疗后应注意检测血小板抑制率,以及时发现抗血小板药物抵抗现象,必要时辨证使用活血化瘀中药治疗。Objective To investigate the relationship between blood stasis syndrome and anti platelet drug resistance in patients with ischemic stroke.Methods One hundred and twenty-six patients with ischemic stroke were divided into non blood stasis syndrome group（n =39）and blood stasis syndrome group（n =87）according to the diagnostic criteria of blood stasis.All patients who were treated with dual antiplatelet therapy for more than one week were performed with the detection of thromboelastogram and the rate of platelet inhibition induced by arachidonic acid（AA）pathway and adenosine diphosphate（ADP）pathway was detected.The platelet inhibition rate and inhibitory effect were observed and compared between the two groups.Results The platelet inhibition rate of ADP receptor pathway in patients with blood stasis syndrome after ischemic stroke was lower than that of non blood stasis syndrome,the incidence of clopidogrel resistance was higher than that of non blood stasis syndrome（P 〈0.05）.Conclusion For patients with ischemic stroke,especially for patients with blood stasis syndrome,platelet inhibitory rate should be tested after oral anti platelet drug therapy in order to discover the phenomenon of anti platelet drug resistance timely.Chinese medicine for promoting blood circulation to remove blood stasis should be used according to syndrome differentiation when necessary.

关 键 词：缺血性脑卒中 血瘀证 抗血小板药物抵抗 花生四烯酸 二磷酸腺苷 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]