腔隙性脑梗死患者阿司匹林抵抗与预后的关系

Relationship between aspirin resistance and prognosis in patients with lacunar cerebral infarction

目的探讨腔隙性脑梗死患者阿司匹林抵抗(AR)与预后的关系。方法以蚌埠医学院第二附属医院2020年6月~2022年6月收治的腔隙性脑梗死患者120例为研究对象,按照脑梗预后优劣分为预后不良组与预后良好组,收集所有患者人口学资料、实验室指标、影像学检查资料,并根据血栓弹力图仪测量血小板抑制率,经随访1年记录患者新发血管事件及死亡情况,采用多因素Logistic回归分析确定腔隙性脑梗死患者AR与预后的关系。结果120例患者中,预后不良34例,发生率为28.33%;两组在性别、合并基础疾病、吸烟、酗酒、血脂、血压等方面比较无明显差异(P>0.05),但年龄、平均动脉压、抗血小板药物用药依从性、AR差异有统计学意义(P<0.05);经多因素Logistic回归分析显示腔隙性脑梗死患者年龄、平均动脉压、抗血小板药物用药依从性、AR与预后明显相关(P<0.05)。结论腔隙性脑梗死患者AR发生的情况较为常见,年龄、平均动脉压、抗血小板药物用药依从性等因素共同影响患者预后。

Objective To investigate the relationship between aspirin resistance(AR)and prognosis in patients with lacunar cerebral infarction.Methods A total of 120 patients with lacunar cerebral infarction treated in the Second Affiliated Hospital of Bengbu Medical College were selected as the study objects from June 2020 to June 2022.According to the prognosis of cerebral infarction,they were divided into poor prognosis group and good prognosis group.Demographic data,laboratory indicators and imaging data of all patients were collected,and the rate of platelet inhibition was measured by thromboelastometer.New vascular events and death were recorded by outpatient or telephone follow-up for one year.Multivariate Logistic regression analysis was used to determine the relationship between AR and prognosis in patients with lacunar cerebral infarction.Results Among 120 patients,34 had poor prognosis(28.33%).There were no significant differences in gender,underlying diseases,smoking,alcoholism,blood lipid and blood pressure between the two groups(P>0.05),but there were statistically significant differences in age,mean arterial pressure,compliance with antiplatelet drugs and AR(P<0.05).It showed that age,mean arterial pressure,compliance with antiplatelet drugs,AR had significant correlation with prognosis of patients with lacunar through multivariate logistic regression analysis(P<0.05).Conclusion AR is a common occurrence in patients with lacunar infarction,and it affects the prognosis cooperation with age,mean arterial pressure,and compliance with antiplatelet drugs.