阿司匹林抵抗和缺血性脑卒中的相关性研究

Correlation between Aspirin Resistance and Ischemic Stroke

目的 研究分析脑卒中与阿司匹林抵抗(aspirin resistance, AR)之间的相关性。方法 方便选取2018年1月—2020年9月在泉州市第一医院神经内科住院的258例缺血性脑卒中患者为研究对象,所有患者入院前均规律服用阿司匹林1周以上。根据光比浊法测定血小板功能,根据GUM标准分为阿司匹林敏感组(AS组,170例)和阿司匹林抵抗组(AR组,88例),提取所有患者DNA后,行聚合酶链反应(PCR)与DNA测序,在规律服用阿司匹林(0.1 g,qd)的基础上对患者进行1年的随访。结果 AS组和AR组的COX-2-765G/C及COX-1-1676A>G等位基因分别频率经过Hard-Weinberg平衡检验,与其相符合,具有广泛代表性;AS组与AR组COX-1-1676A>G位点G等位基因携带及COX-2-765G/C基因携带C等位基因相比较,差异无统计学意义(P>0.05);AR组缺血性脑卒中复发率(18.18%)明显高于AS组(8.82%),差异有统计学意义(χ^(2)=4.803,P=0.028);而COX-1-1676A>G其G等位基因携带和缺血性脑卒中复发相比存在相关性(OR=0.28,95%CI=0.05~2.31,P<0.05)。结论 AR与缺血性脑卒中复发有一定的相关性,而COX-2-765G/C基因和COX-1-1676A>G基因与缺血性脑卒中患者发生AR与之间的相关性需进一步研究。

Objective To investigate the association between stroke and aspirin resistance(AR).Methods 258 pa⁃tients with ischemic stroke admitted to the Department of Neurology of Quanzhou First Hospital from January 2018 to September 2020 were conveniently selected as the study subjects were.All patients took aspirin regularly for more than 1 week before admission.Platelet function was determined by optical turbidimetry and divided into aspirin sensi⁃tive group(AS group,170 cases)and aspirin resistant group(AR group,88 cases)according to GUM criteria.After DNA was extracted from all patients,PCR and DNA sequencing were performed,and the patients were followed up for 1 year on the basis of regular aspirin(0.1 g,qd).Results The frequencies of COX-2-765G/C and COX-1-1676A>G alleles in AS group and AR group were tested by Hard-Weinberg equilibrium test,which were consistent with them and widely representative;there was no statistically significant difference between AS group and AR group in COX-1-1676A>G allele and Cox-2-765 G/C gene carrying C allele(P>0.05);the recurrence rate of ischemic stroke in AR group(18.18%)was significantly higher than that in AS group(8.82%),and the difference was statistically significant(χ^(2)=4.803,P=0.028);COX-1-1676A>G was associated with ischemic stroke recurrence(OR=0.28,95%CI=0.05-2.31,P<0.05).Conclusion There is a certain correlation between AR and ischemic stroke recurrence,and the correla⁃tion between COX-2-765G/C gene and COX-1-1676A>G gene and AR in patients with ischemic stroke needs fur⁃ther study.