反复发作的缺血性卒中

Recurrent Ischemic Stroke

部分患者对抗血小板药物表现为低反应性或无反应,接受抗血小板规范治疗后仍发生心脑血管事件。本例患者为63岁女性,长期服用阿司匹林和氯吡格雷,多次出现肢体乏力,行头颅磁共振扫描均提示急性脑梗死。后经血小板聚集试验、闭合试验及基因检测证实,该患者存在阿司匹林和氯吡格雷低反应性。改服西洛他唑,随访1年余,未再发生心脑血管事件。

In some patients who have low or no response to antiplatelet drugs,cardiovascular and cerebrovascular events still happen with standard antiplatelet therapy. In this case report,a 63-year-old woman appeared repeated episodes of limb weakness,although she had taken antiplatelet drugs,i. e. aspirin and clopidogrel,for a long time. Every time,magnetic resonance imaging showed that she had a fresh cerebral infarction; and at the same time,platelet aggregation test,clotting test,and gene test indicated clopidogrel and aspirin resistance,which meant low or no response to antiplatelet therapy. We changed immediately to cilostazol and followed up for more than 1 year. This patient had no recurrence of cardiovascular and cerebrovascular events anymore.