双联抗血小板聚集治疗轻型缺血性脑卒中的血小板功能与卒中复发的相关性  

Correlation between platelet function and stroke recurrence in mild ischemic stroke treated with dual antiplatelet therapy

作　　者：任金岩 宋晓宇 高飞[1] 梁辉[2] 于天霞[2] 郑娟[2] 黄梅 孔敏[2] REN Jinyan;SONG Xiaoyu;GAO Fei;LIANG Hui;YU Tianxia;ZHENG Juan;HUANG Mei;KONG Min(Health Management Center,the Affiliated Hospital of Qingdao University,Qingdao 266555,Shandong,P.R.China;Department of Neurology,Yantaishan Hospital,Yantai 264003,Shandong,P.R.China)

机构地区：[1]青岛大学附属医院健康管理中心,山东青岛266555 [2]烟台市烟台山医院神经内科,山东烟台264003

出　　处：《滨州医学院学报》2022年第3期205-208,共4页Journal of Binzhou Medical University

基　　金：山东省医药卫生科技发展计划(2017WSA06086)。

摘　　要：目的研究双联抗血小板聚集治疗轻型缺血性脑卒中的血小板功能与卒中复发的相关性,并探索经规范二级预防的轻型缺血性脑卒中复发的危险因素。方法收集2018年1月至2019年12月期间发病72小时内入住烟台市烟台山医院神经内科的非心源性轻型缺血性脑卒中患者371例。给予规范的双联抗血小板聚集(3周)、降脂、控制血压、血糖等治疗。出院后随访12个月。随访期间规范二级预防用药的144例患者纳入本研究,记录缺血性卒中复发情况。比较卒中复发组和非复发组的血小板功能,采用二元Logistic回归分析探讨规范二级预防的轻型缺血性卒中复发的危险因素。结果经规范二级预防的轻型缺血性卒中患者1年内卒中复发率为13.9%。卒中复发组7天的血小板最大聚集率MAR_(AA)高于非复发组;两组的血小板最大聚集率MAR_(ADP)无差异。Logistic回归分析显示年龄和脑卒中史是规范双抗(3周)二级预防的轻型缺血性卒中1年内卒中复发的独立危险因素。结论该研究不能证实轻型缺血性卒中短期双联抗血小板聚集(3周)后的血小板功能与1年内卒中复发具有相关性。年龄和卒中史是经规范二级预防后的轻型缺血性卒中复发的独立危险因素。Objective To explore the correlation between platelet function and stroke recurrence in mild stroke treated with dual antiplatelet therapy and the risk factors of mild stroke recurrence after standardized secondary prevention.Methods Three hundred and seventy-one patients with non-cardiogenic mild cerebral infarction admitted to the Department of Neurology of YantaishanHospital from January 2018 to December 2019 were collected.Standard treatment of antiplatelet aggregation(3 weeks),lipid-lowering,blood pressure control and blood glucose were given.The patients were followed up for 12 months after discharge.One hundred and forty-four patients with standardized secondary preventive drugs during follow-up were included in this study,and the recurrence of ischemic stroke was recorded.The platelet function of recurrent stroke group and non recurrent stroke group was compared,and the risk factors of mild stroke recurrence with standardized secondary prevention were discussed by binary logistic regression analysis.Results The recurrence rate of mild ischemic stroke within 1 year was 13.9%after standardized secondary prevention.The maximum platelet aggregation rate(MAR_(AA))at 7 days in the stroke recurrence group was higher than that in the non recurrence group.There was no difference in the maximum platelet aggregation rate(MAR_(ADP))between the two groups.Logistic regression analysis showed that age and stroke historywere independent risk factors for stroke recurrence with standardized secondary prevention within one year.Conclusion This study could not confirm the correlation between platelet function after short-term dual antiplatelet therapy(3 weeks)in mild stroke and stroke recurrence within 1 year.Age and stroke history are independent risk factors of recurrence of mild stroke with standardized secondary prevention.

关 键 词：双抗治疗 非心源性轻型缺血性脑卒中 血小板功能 卒中复发 

分 类 号：R743.1[医药卫生—神经病学与精神病学]