阿司匹林抵抗对大动脉粥样硬化性脑梗死复发的影响

The influence of aspirin resistance on cerebral infarction recurrence with large artery atherosclerosis

目的观察阿司匹林抵抗（aspirinresistance，AR）对大动脉粥样硬化性脑梗死（large artery ath erosclerosis cerebral infarction，L从CI）复发的影响。方法选择阳东县人民医院首次发生LAACI患者269例，人院后即服用阿司匹林200mg，在7-10d后利用比浊法检测血小板聚集率，分为AR组40例，阿司匹林敏感组（aspirin sensitivity，AS）229例，进行随访6～12个月；根据脑梗塞复发的情况分为大动脉粥样硬化复发（largeartery atherosclerosi srecurrence，LAAR）组38例和大动脉粥样硬化无复发（notlarge artery athero sclerosis recurrence，NLAAR）组231例，观察AR患者的危险因素，同时观察LAAR与AR之间的关系。结果单因素分析中AR组的LAAR显著高于AS组（34．2％vs11．7％，P=0．000），跟NLAAR组比较LAAR组患糖尿病、AR、年龄较大的比例均明显升高（P〈0．05或0．01）；多因素分析中LAAR与AR明显相关（OR=4．692，95％CI=1．052～15．675，P=0．005）。结论AR是LAAR的独立危险因素，能够增加LAAR的风险。

Objective To observe the influence of aspirin resistance on cerebral infarction recurrence with large artery atherosclerosis and the long-term curative effect of aspirin. Methods We collected 269 patients with ischemic stroke during November 2012 to November 2013 in Department of Neurology of yang-dong People＇s hospital, all patients took aspirin 200 mg/d , and then were divided into AR group and aspirin sensitivity（AS）group according to use Turbidimetry to measure the platelet aggregation rate after taking aspirin 7 0 10 d. Depending on the recurrence of cerebral infarction, the patients were divided into the group of large artery atherosclerosis recurrence （LAAR）group （229 cases）and not large artery atherosclerosis recurrence （NLAAR） group（231 cases）after following up 6-12 months, and observed the risk factors of patients with AR and the relationship between LAAR and AR. Results In single factor analysis, LAAR in AR group was significantly higher than the AS group （vs 11.7- 34. 2%, P = 0. 000）. LAAR in patients in LAAR with dia- betes, AR, older were significant different （P〈0. 05 or 0. 01）, compared with NLAAR group. In multiple factors analysis, LAAR was significantly related with AR （OR = 4. 692, 95% CI = 1. 052- 15. 675, P = 0. 005）. Conclusions AR is independent risk factors of LAAR, and can increase the risk of LAAR.