缺血性脑卒中阿司匹林抵抗危险因素的Meta分析

Risk factors for aspirin resistance in ischemic stroke patients:A Meta-analysis

目的运用Meta分析方法对缺血性脑卒中阿司匹林抵抗(AR)的危险因素进行探讨与研究。方法计算机检索PubMed数据库、Excerpt Medica Database数据库、WOS科学网、Cochrane Library、CBM、中国知网数据库、万方数据知识服务平台,时间为各平台建立到2021年11月30日。本文质量评价运用NOS量表,提取相关数据。本篇Meta分析选用RevMan5.3软件。结果共纳入文献27篇,患者5217例。经Meta分析结果显示,缺血性脑卒中AR的危险因素为:女性(OR=2.28,95%CI=1.61~3.23,P<0.01);糖尿病(OR=2.71,95%CI=1.84~4.00,P<0.01);吸烟(OR=2.59,95%CI=1.89~3.56,P<0.01);高胆固醇血症(OR=3.29,95%CI=1.39~7.79,P<0.01);高脂血症病史(OR=2.96,95%CI=1.89~4.62,P<0.01);C3435T基因组TT基因(OR=2.26,95%CI=1.65~3.08,P<0.01);GP IIb HPA-3基因型bb基因(OR=4.63,95%CI=3.08~6.96,P<0.01);高血压(OR=1.74,95%CI=1.06~2.88,P<0.05);血管紧张素转换酶抑制剂(OR=2.56,95%CI=1.53~4.27,P<0.01);既往中风史(OR=4.23,95%CI=2.85~6.29,P<0.01)。结论明确缺血性脑卒中AR的危险因素至关重要,具有一定的理论与实践意义,可为缺血性脑卒中AR预防决策的制定提供循证依据。

Objective Meta-analysis was used to investigate the risk factors of aspirin resistance in ischemic stroke.Methods PubMed,Excerpt Medica Database,Web of Science,Cochrane Library,CBM,CNKI and WanFang were searched by computer.The retrieval time was from the establishment of each database to November 30,2021.NOS scale was used to evaluate the quality of the included literature and extract relevant data,and RevMan5.3 software was used for Meta analysis.Results A total of 27 articles and 5217 patients were included.According to the results of Meta-analysis,risk factors for aspirin resistance in patients with ischemic stroke were:female(OR=2.28,95%CI=1.61-3.23,P<0.01),diabetic(OR=2.71,95%CI=1.84-4.00,P<0.01),smoking(OR=2.59,95%CI=1.89-3.56,P<0.01),hypercholesteremia(OR=3.29,95%CI=1.39-7.79,P<0.01),history of hyperlipidemia(OR=2.96,95%CI=1.89-4.62,P<0.01),TT gene of C3435T genome(OR=2.26,95%CI=1.65-3.08,P<0.01),bb gene of GP IIb HPA-3 genotypes(OR=4.63,95%CI=3.08-6.96,P<0.01),hypertension(OR=1.74,95%CI=1.06-2.88,P<0.05),angiotensin-converting enzyme inhibitors(OR=2.56,95%CI=1.53-4.27,P<0.01)and previous stroke(OR=4.23,95%CI=2.85-6.29,P<0.01).Conclusion It is very important to clarify the risk factors of aspirin resistance in ischemic stroke,which has certain theoretical and practical significance,and provides evidence-based basis for the decision-making of AR prevention in ischemic stroke.