急性脑梗死患者发生阿司匹林抵抗危险因素分析.docVIP

急性脑梗死患者发生阿司匹林抵抗危险因素分析 　　[摘要]目的 系统研究急性脑梗死患者出现阿司匹林抵抗（AR）现象的相关影响因素。方法 选取我院2013年12月～2015年12月收治的150例急性脑梗死患者的临床资料进行回顾性研究，借助于血栓弹力图，测量患者的花生四烯酸（AA）诱导途径中的血小板抑制率。AR为血小板抑制率≤20%，阿司匹林半抵抗（ASR）为血小板抑制率处于20%～50%，阿司匹林敏感（AS）为血小板抑制率50%，结合上述标准将150例患者进行分组，在分析AR发生率的基础上，对各组间的特征差异进行分析，并总结AR与ASR的相关危险因素。结果 本组患者中，AR的发生率是34.0%（51/150），ASR发生率是19.3%（29/150）；AR+ASR组的高敏C反应蛋白（hs-CRP）水平显著高于AS组，差异有统计学意义（P0.05）；经Logistic回归分析，AR与ASR的危险因素包括血小板计数（PLT）和hs-CRP水平。结论 针对急性脑梗死患者，其出现AR的危险因素包括PLT和炎症状态，需要定期检查患者的血常规和实验室指标，并及时调整临床用药方案。 　　[关键词]急性脑梗死；阿司匹林抵抗；危险因素 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721（2016）07（c）-0057-03 　　[Abstract]Objective To systematically study relevant influence factors of aspirin resistance （AR） phenomenon in patients with acute cerebral infarction. Methods Clinical data about 150 patients with acute cerebral infarction entering our hospital from December 2013 to December 2015 were selected for retrospective study.With the aid of thrombelastogram，we measured the blood platelet inhibition ratio in the induction pathway of patients′arachidonic acid （ASR）.AR meant that the blood platelet inhibition ratio was smaller than or equal to 20%；aspirin semi-resistance （ASR） meant that the blood platelet inhibition ratio was between 20% and 50%；aspirin sensitivity （AS） meant that the blood platelet inhibition ratio was greater than 50%.By combining with the above standards，the above 150 patients were divided into different groups.Based on analysis of AR occurrence rate，characteristic differences among various groups were analyzed.Moreover，relevant risk factors of AR and ASR were summarized.Results Among patients of this group，the occurrence rate of AR was 34.0% （51/150） and the occurrence rate of ASR was 19.3% （29/150）.The high-sensitivity C-reactive protein （hs-CRP） level of AR+ASR group was obviously higher than that of AS group，and the difference presented statistical significance （P0.05）.According to Logistic regression analysis，risk factors of AR and ASR included blood platelet count and hs-CRP