影响脑梗死患者阿司匹林抵抗的相关因素及复发情况分析

Analysis of factors affecting aspirin resistance in patients with cerebral infarction and its recurrence

目的探究阿司匹林抵抗(AR)对脑梗死复发的影响, 并分析患者发生AR的相关危险因素。方法回顾性研究, 分析商丘市第一人民医院2020年1月至2022年1月收治的202例脑梗死患者的资料, 患者入院后给予相应治疗, 均连续治疗1周以上。通过光比浊法测血小板聚集试验检查患者AR情况, 依据AR情况将202例患者分为AR组(63例)与阿司匹林敏感(AS)组(139例)。比较两组患者的一般资料, 包括性别、年龄、高血压、糖尿病、冠心病、高脂血症、吸烟、饮酒、心房颤动、AR、三酰甘油、总胆固醇(TC)、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、C-反应蛋白、同型半胱氨酸、抗血小板药物依从性、氧化型低密度脂蛋白胆固醇(ox-LDL)等。将比较后有统计学意义的指标纳入多元Logistic回归分析中, 分析影响脑梗死患者发生AR的独立性危险因素。比较两组患者的2年复发率。结果与AS组患者比较, AR组患者脑梗死复发、TC、ox-LDL差异均有统计学意义(P<0.05)。多元Logistic回归分析显示脑梗死复发(OR=15.410, 95%CI:5.504~43.146, P<0.001)、TC(OR=0.454, 95%CI:0.313~0.660, P<0.001)是影响脑梗死患者AR的独立危险因素。AR组2年复发率11.11%(7/63)显著高于AS组3.60%(5/139)(P<0.05)。结论脑梗死复发、TC是脑梗死患者AR的独立危险因素, AR会进一步增加脑梗死复发的风险, 因此, 对患者是否存在AR进行监测对于预防脑梗死复发具有实际意义。

Objective To explore the effect of aspirin resistance(AR)on the recurrence of cerebral infarction and to analyze risk factors related to the development of AR in such patients.Methods A retrospective study was conducted to analyze the data of 202 cerebral infarction patients admitted to Shangqiu First People's Hospital between January 2020 and January 2022.All patients were given continuous treatment in accordance with their conditions for more than one week.The AR status of the patients was examined by the turbidimetric platelet aggregation test.Based on AR status,202 patients were divided into an AR group(63)and an aspirin-sensitive(AS)group(139).General data of the two groups were compared concerning sex,age,hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking,drinking,atrial fibrillation,AR,triglycerides,total cholesterol(TC),high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,C-reactive protein,homocysteine,compliance with antiplatelet drug therapy,and oxidized low-density lipoprotein(ox-LDL),among others.Parameters showing statistical significance in the comparison were further examined in multivariate logistic regression analysis to identify independent risk factors for the occurrence of AR in patients with cerebral infarction.The 2-year recurrence rates between the two groups were compared.Results There were statistically significance differences in cerebral infarction recurrence,TC and ox-LDL between patients in the AR group and in the AS group(P<0.05).Subsequent multivariate logistic regression analysis showed that cerebral infarction recurrence(OR=15.410,95%CI:5.504-43.146,P<0.001)and TC(OR=0.454,95%CI:0.313-0.660.P<0.001)were independent risk factors affecting AR in patients with cerebral infarction.The 2-year recurrence rate in the AR group(11.11%or 7/63)was significantly higher than in the AS group(3.60%or 5/139)(P<0.05).Conclusions Cerebral infarction recurrence and TC are independent risk factors for AR in patients with cerebral infarction.and AR will further increase the risk of cerebral infarction recurrence.Therefore,monitoring the presence of AR in patients has practical value in preventing cerebral infarction recurrence.