文章摘要
孙国兵，陈延，郭珍立，黄敏.大动脉粥样硬化型脑梗死患者发生阿司匹林抵抗的危险因素分析[J].神经损伤功能重建,2020,15(4):194-197
大动脉粥样硬化型脑梗死患者发生阿司匹林抵抗的危险因素分析
Analysis of Risk Factors for Aspirin Resistance in Patients with Large-Artery AtheroscleroticCerebral Infarction
  
DOI：
中文关键词: 大动脉粥样硬化型脑梗死  血栓弹力图  阿司匹林抵抗  血小板抑制率
英文关键词: large-artery atherosclerotic cerebral infarction  thromboelastogram  aspirin resistance  platelet inhibition rate
基金项目:重大疑难疾病中 西医临床协作试 点 项 目（No. 国 中 医 药 办 医 政 发 《2-18》3号-39）
作者单位
孙国兵，陈延，郭珍立，黄敏 湖北省中西医结 合医院神经内科 
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中文摘要:
      目的：探讨大动脉粥样硬化型脑梗死患者阿司匹林抵抗（AR）的临床特征，并分析AR发生的危险因 素。方法：依照TOAST分型标准，选择发病7 d内急性大动脉粥样硬化型脑梗死患者160例，统一给予拜阿 司匹林（200 mg，1次/日）口服抗血小板聚集治疗；7 d后用血栓弹力图（TEG）检测血小板抑制率，并根据结 果将患者分为阿司匹林敏感（AS）组和AR组；比较2组临床资料及生化指标水平，分析AR的危险因素。结 果：TEG检测结果显示，AR者42例（26.3%），AS者118 例；2组花生四烯酸抑制率分别为（42.6±18.9）%和 （76.3±15.8）%（P＜0.05）。单因素分析结果显示，AR组吸烟、饮酒、糖尿病史患者比例及血清Hcy、hs-CRP水 平显著高于AS组（P＜0.05）。Logistic回归分析显示，糖尿病史、吸烟及高Hcy是AR发生的独立危险因素。 结论：大动脉粥样硬化型脑梗死患者中存在AR，糖尿病史、吸烟史及高Hcy水平是AR发生的独立危险因素。
英文摘要:
      To investigate the clinical characteristics of aspirin resistance (AR) in patients with large-artery atherosclerotic cerebral infarction and to analyze the risk factors for AR. Methods: According to the TOAST classification criteria, 160 patients with acute large-artery atherosclerotic cerebral infarction within 1 week of onset were recruited and treated with oral aspirin (200 mg, once a day) for anti-platelet aggregation. Thromboelastography (TEG) was used to detect platelet inhibition rate after 1 week of treatment, and based on these results, patients were divided into the aspirin sensitive (AS) group and AR group. The clinical data and biochemical indicators of the two groups were compared and analyzed to determine the risk factors of AR. Results: The TEG results showed 42 patients (26.3% ) with AR and 118 patients with AS; the inhibition rates of arachiodonicacid in the two groups were (42.6±18.9)% and (76.3±15.8)% respectively (P<0.05). Univariate analysis showed that, compared with that of the AS group, the proportion of patients with a history of diabetes, smoking, and drinking and the serum Hcy and hs-CRP levels were significantly higher in the AR group (P<0.05). Logistic multivariate analysis showed that diabetic history, smoking and high Hcy levels are independent risk factors of AR. Conclusion: AR may exist in patients with large-artery atherosclerotic cerebral infarction. A history of diabetes and smoking and high Hcy levels are independent risk factors for AR occurrence.
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