女性脑梗死患者阿司匹林抵抗及相关因素分析

Aspirin resistance and its risk factors in female ischemic stroke patients

目的 检测女性脑梗死患者阿司匹林抵抗（AR）发生率,分析其影响因素。方法 纳入连续住院的女性脑梗死患者116例,根据是否发生AR分为AR组47例和阿司匹林敏感（AS）组69例。所有入选者晨起顿服阿司匹林肠溶片100mg/d,连续服药10d后,测定花生四烯酸途径的血小板聚集抑制率及糖化血清蛋白水平,比较2组一般临床资料的差异。患者根据糖化血清蛋白水平又分为血糖控制良好组67例（〈236μmol/L）和血糖控制欠佳组49例（≥236μmol/L）,比较2组AR的比率。用logistic二元回归分析影响AR的相关因素。结果 AR组体质量明显高于AS组,差异有统计学意义[（66.9±10.2）kg vs（63.5±7.9）kg,P〈0.05]。血糖控制良好组较血糖控制欠佳组患者AR的发生率明显降低,差异有统计学意义（28.4%vs 57.1%,P〈0.01）。多因素logistic二元回归分析显示,血糖控制是发生AR的危险因素（OR=3.368,95%CI：1.550~7.320,P=0.002）。结论 女性脑梗死患者存在相当比例AR,体质量及血糖控制情况可能影响AR的发生。

Objective To analyze the risk factors for aspirin resistance （AR） by observing its incidence in female ischemic stroke patients. Methods One hundred and sixteen female ischemic stroke patients were divided into AR group （n=47） and aspirin sensitive group （n=69） ,according to the arachidonic acid （AA） inhibitory rate. All the patients were given 100 mg aspirin tablet in the morning for 10 days. The inhibition rate of AA on platelet aggregation and the serum glycosy lated serum protein level were then measured. The general clinical data were compared. The patients were further divided into glycosylated serum protein〈236 μmol/L group （n= 67） and gly cosylated serum protein 〈236 μmol/L group （n=49）. The incidence of AR in two groups was compared. The risk factors for AR were analyzed by logistic binary regression analysis. Results The body weight was significantly higher in AR group than in aspirin sensitive group （66. 9 ± 10.2 kg vs 63.5±7.9 kg,P〈0.05）. The incidence of AR was significantly higher in glycosylated serum protein ≥ 236 μmol/L groug than glycosylated serum protein 〈 236 μmol/L group （57. 1% vs 28.4% ,P〈0.01）. Multivariate logistic binary regression analysis showed that glyce mic control was the risk factor for AR（OR：3. 368,95%CI：1. 550-7. 320,P：0. 002）. Conclusion The incidence of AR is rather high in female ischemic stroke patients. Body weight and glycemic control affect the incidence of AR.