阿司匹林单药抗血小板治疗的缺血性卒中患者复发危险因素分析  

Risk Factors of Recurrence in Patients with Ischemic Stroke Treated with Aspirin Single Drug Antiplatelet Therapy

作　　者：李骞[1] 冯朴琼 姚勤[1] 陈寒梅 赵婷 吴晖[1] LI Qian;FENG Puqiong;YAO Qin;CHEN Hanmei;ZHAO Ting;WU Hui(Dept.of Pharmacy,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院临床药学中心,云南昆明650032

出　　处：《昆明医科大学学报》2024年第1期78-82,共5页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(2019J1237);云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(202101AY070001-090)。

摘　　要：目的 探讨使用阿司匹林进行单抗二级预防的缺血性卒中患者复发的危险因素。方法 对200例使用阿司匹林单抗治疗1 a后的轻型和中型缺血性卒中患者进行回顾性的分析,根据患者卒中是否复发分为未复发组和复发组,使用单因素分析和多因素Logistic回归模型分析探讨相关指标是否为复发的高危因素,并利用ROC曲线预测危险因素的临界值。结果 单因素分析显示有统计学意义的危险因素为血小板计数、同型半胱氨酸水平和PEAR1基因rs12041331位点的A等位基因(P <0.05)。多因素分析表明复发的独立危险因素为同型半胱氨酸水平[OR=1.16(1.089~1.240),P <0.001]。采用ROC预测的临界值为8.35μmol/L(灵敏度0.847,特异度0.532)。结论 PEAR1基因rs12041331位点的A等位基因、血小板计数和Hcy水平是导致阿司匹林单抗治疗的缺血性卒中患者复发的危险因素,Hcy水平是导致阿司匹林单抗治疗的缺血性卒中患者复发的独立危险因素,可利用Hcy水平预测阿司匹林单抗治疗的缺血性卒中患者复发的风险。Objective To investigate the risk factors of relapse in patients with ischemic stroke using aspirin for single drug antiplatelet therapy.Methods A retrospective analysis was conducted on 200 patients with mild and medium ischemic stroke after 12 months of single drug treatment with aspirin,and the patients were divided into non-recurrence group and recurrence group according to the recurrence of stroke.Univariate analysis and multivariate logistic regression model were used to explore whether the related indicators were risk factors for recurrence.The ROC curve was used to predict the critical value of risk factors.Results Univariate analysis showed that platelet count,Hcy level and the A allele at rs12041331 site of PEAR1 gene were statistically significant risk factors(P<0.05).Multifactor analysis showed that the independent risk factor for recurrence was homocysteine level[OR=1.16(1.089-1.240),P<0.001)].The critical value of ROC prediction was 8.35µmol/L(sensitivity 0.847,specificity 0.532).Conclusions The Hcy level,platelet count and A allele at rs12041331 site of PEAR1 gene are risk factors for recurrence in patients with ischemic stroke treated with aspirin for Single drug antiplatelet therapy.Hcy level is independent risk factor and can be used to predict the risk of recurrence.

关 键 词：缺血性卒中 复发 PEAR1基因 同型半胱氨酸 危险因素 

分 类 号：R968[医药卫生—药理学]