脑梗死患者血小板功能及其复发的相关性研究  

Relationship between platelet function and recurrence of cerebral infarction

作　　者：宋晓宇 任金岩 梁辉[1] 高飞[2] 王英[1] 唐剑华 孔敏[1] Song Xiaoyu;Ren Jinyan;Liang Hui;Gao Fei;Wang Ying;Tang Jianhua;Kong min(Department of Neurology,Yantaishan Hospital,Yantai 264000,Shandong Province,China)

机构地区：[1]烟台市烟台山医院神经内科,264000 [2]青岛大学附属医院健康管理中心

出　　处：《中华老年心脑血管病杂志》2022年第5期515-518,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：山东省医药卫生科技发展计划项目(2017WSA06086)。

摘　　要：目的探讨非心源性轻型前循环脑梗死患者应用抗血小板药物后血小板功能与脑梗死复发的相关性。方法收集2018年1月~2019年12月发病72 h内入住烟台市烟台山医院神经内科的急性轻型前循环脑梗死患者128例,根据随访1年有无脑梗死复发分为复发组18例和非复发组110例,入院后给予抗血小板治疗,检测抗血小板治疗前(基线)及治疗7 d后的血小板功能,包括花生四烯酸诱导的血小板最大聚集率(MAR_(ADP))和二磷酸腺苷诱导的血小板最大聚集率(MAR_(ADP))。结果复发组年龄、高血压、糖尿病、既往脑梗死史及症状性大血管狭窄比例明显高于非复发组,差异有统计学意义(P<0.05,P<0.01)。所有患者抗血小板治疗7 d MAR_(ADP)和MAR_(ADP)明显低于治疗前[(38.7±10.3)%vs(49.5±12.8)%,(47.1±11.0)%vs(52.2±12.1)%,P<0.01]。复发组症状性大血管狭窄患者治疗7 d MAR_(ADP)明显高于非复发组症状性大血管狭窄患者,差异有统计学意义[(46.2±9.5)%vs(36.0±12.4)%,(P=0.022)]。结论抗血小板药物可显著降低血小板最大聚集率,血小板功能可能与复发脑梗死有一定相关性。Objective To study the relationship between platelet function and recurrence of cerebral infarction in patients with non-cardiogenic mild anterior circulation cerebral infarction after treatment with antiplatelet drugs.Methods Of the 128 patients with acute mild anterior circulation cerebral infarction admitted to our hospital within 72 hours after onset of the disease from January 2018 to December 2019 included in the study were divided into cerebral infarction recurrence group(n=18)and non-cerebral infarction recurrence group(n=110)according to whether they had cerebral infarction recurrence after 1-year follow-up.The patients were treated with antiplatelet drugs after admission.Their platelet functions,including MAR_(ADP)and MAR_(ADP),were tested before and after 7 days of treatment.Results The age was significantly older,the incidence of hypertension,DM,and symptomatic great vessel stenosis was significantly higher and the past cerebral infarction history was significantly longer in cerebral infarction recurrence group than in non-cerebral infarction recurrence group(P<0.05,P<0.01).The MAR_(ADP)and MAR_(ADP)were significantly lower in two groups after treatment than before treatment(38.7%±10.3%vs 49.5%±12.8%,47.1%±11.0%vs 52.2%±12.1%,P<0.01).The MAR_(ADP)was significantly higher in patients with symptomatic great vessel stenosis of cerebral infarction recurrence group than in those with symptomatic great vessel stenosis of non-cerebral infarction recurrence group(46.2%±9.5%vs 36.0%±12.4%,P=0.022).Conclusion Antiplatelet drugs can effectively reduce the MAR.Platelet function is related with the recurrence of cerebral infarction.

关 键 词：脑梗死 血小板聚集抑制剂 血小板 复发 

分 类 号：R743.33[医药卫生—神经病学与精神病学]