关于缺血性脑卒中的阿司匹林抵抗的临床分析

Clinical analysis of aspirin resistance among the ischemic stroke patients

目的证实阿司匹林抵抗的存在,观察多个因素和阿司匹林抵抗之间的关系。方法 103例急性缺血性脑卒中患者,入院2天内完成首次静脉血采集,之后除接受同等治疗外,所有患者服阿司匹林100 mg,连服10天,服用最后一剂后24 h内完成第2次采集。检测最大血小板聚集率。结果阿司匹林抵抗(AR)存在,血小板聚集试验结果 AR发生率为8.73%,阿司匹林半敏感(ASR)者为26.21%,阿司匹林敏感(AS)为64%。在AR或ASR患者中血小板聚集与糖尿病、高血压,高同型半胱氨酸血症、高脂血症等因素无关。结论 AR在脑梗死患者中确实存在。若有AR存在,应及时换用其它安全有效的抗血小板制剂长期服用,预测AR及抗血小板治疗个体化,将是未来抗血小板治疗的方向。

Objective To prove the existence of aspirin resistance and discover the relations between many factors and aspirin resistance.Methods After their hospitalization,103 patients with acute ischemic stroke completed the first collection within 2 days,whose venous blood in empty stomach were the blood samples.Later,all these patients took aspirin medicines 100 mg once after breakfast for 10 days continuously.After they took the last dose,the second collection was completed within 24 h.And the detection of maximal aggregation ratio of platelet was done later.Results ①Aspirin resistance existed in patients with cerebral infarction.AR rate was calculated to be 8.73%,ASR was calculated to be 26.21% and AS was calculated to be 64%.②Platelet aggregation had nothing to do with diabetes melitus,hypertension,hyperhomocysteinemia and hyperlipidemia etc in patients with AR or ASR.Conclusion AR is proved to exist among cerebral infarction patients.If AR exists,it should be promptly replaced by other safe and effective antiplatelet agents for a long time.And prediction of AR and antiplatelet therapy individually will become the future direction of antiplatelet therapy.