动脉粥样硬化性脑梗死患者氯吡格雷抵抗与脑梗死复发的相关性研究

Study of the relationship between clopidogrel resistance and recurrent atherosclerotic cerebral infarction

目的探讨动脉粥样硬化性脑梗死(atherosclerosis cerebral infarction,ATCI)患者氯吡格雷抵抗(clopidogrel resistance,CR)与ATCI复发的相关性。方法回顾性分析2012年1月至2014年12月收治的急性ATCI患者共162例,分为初发组和复发组,初发组52例,复发组110例。复发组院外常规服用氯吡格雷75mg/d,初发组入院即服同等剂量氯吡格雷,7天后使用血栓弹力图检测CR情况,使用单因素分析明确CR与ATCI的相关性,并使用多元Logistic回归分析确定其影响程度。结果复发组CR的比例明显高于初发组,差异有显著性(P<0.05)。Logistic回归分析显示,两组之间CR(OR=1.912,P=0.016)差异具有显著性。结论 CR是ATCI复发的独立危险因素。

Objective To explore relationship between clopidogrel resistance and recurrence of atherosclerotic cerebral infarction（ATCI） in patients with ATCI. Method From January 2012 to December 2014, 162 patients with acute ATCI were analyzed retrospectively and were divided into first group（n=110） and recurrent group（n=52）. The patients in recurrent group were treated with clopidogrel, 75 mg a day before admission. And all patients were treated with clopidogrel, 75 mg a day for 7 days after admission. Their CR was detected by thrombelastograph. Analyzed the relationship between CR and recurrent ATCI with single factor analysis and their affected degree was determined with mutiple logistic regression analysis. Result The proportion of CR was all significantly higher in the recurrent group than in the first group（P〈0.05）. The multivariable logistic regression analysis revealed that CR（OR=1.912, P=0.016） was independent risk factors for recurrent ATCI. Conclusion CR（OR=1.912, P=0.016） was a independent risk factor for recurrent ATCI.