急性脑梗死患者阿司匹林抵抗危险因素分析

doi:10.3969/j.issn.1673-8640.2013.09.008

检验医学 ›› 2013, Vol. 28 ›› Issue (9): 765-769.DOI: 10.3969/j.issn.1673-8640.2013.09.008

急性脑梗死患者阿司匹林抵抗危险因素分析

邓琳^¹,邱丽君^¹,顾青^¹,王根发^²

1.上海交通大学医学院附属新华医院检验科,上海 200092;
2.上海交通大学医学院附属新华医院老年医学科,上海 200092

收稿日期:2012-09-17 修回日期:2013-09-25 出版日期:2013-09-15 发布日期:2013-09-25
通讯作者: 王根发,联系电话:021-25077721。
作者简介:邓琳,女,1982年生,博士,检验医师,主要从事心脑血管临床研究工作。

Analysis on risk factors for aspirin resistance in patients with acute cerebral infarction

DENG Lin^¹,QIU Lijun^¹,GU Qing^¹,WANG Genfa^²

1.Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;
2. Department of Geronotology, Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China

Received:2012-09-17 Revised:2013-09-25 Online:2013-09-15 Published:2013-09-25

摘要/Abstract

摘要：

目的探讨急性脑梗死患者阿司匹林抵抗(AR)现象及其影响因素。方法收集330例急性脑梗死患者,根据血栓弹力图测定花生四烯酸(AA)诱导途径的血小板抑制率。血小板抑制率≤20%即判定为AR,抑制率在20%～50%之间则判定为阿司匹林半抵抗(ASR),抑制率>50%即为阿司匹林敏感(AS)。根据上述标准将患者进行分组,研究AR的发生率,并分析各组间各项临床特征的差异,采用Logistic回归分析影响AR与ASR的危险因素。结果 330例急性脑梗死患者中AR发生率为33.9％,ASR发生率为19.7％。与AS组相比,AR+ASR组中高敏C反应蛋白(hs-CRP)水平明显升高(P<0.05)。≥65岁患者中,高风险患者AR+ASR发生率显著升高(P<0.05)。Logistic回归分析表明血小板计数[OR=0.996,95％可信区间(CI):0.991～0.999,P=0.041]和hs-CRP(OR=0.972,95％CI:0.959～0.996,P=0.014)是发生AR与ASR的危险因素。结论急性脑梗死患者AR的发生率较可能与血小板数量和患者炎症状态有关。

关键词: 脑梗死, 阿司匹林抵抗, 血栓弹力图

Abstract:

Objective To investigate the aspirin resistance (AR) and its risk factors in patients with acute cerebral infarction. Methods A total of 330 patients with acute cerebral infarction were enrolled. According to the platelet inhibition rate of arachidonic acid (AA) by thrombelastography, the patients were classified into AR group (platelet inhibition rate ≤20%), aspirin semi-resistance (ASR) group (platelet inhibition rate 20%-50%) and aspirin sensitivity (AS) group (platelet inhibition rate >50%). The incidence rate of AR was analyzed, the difference of clinical characteristics was analyzed, and Logistic regression analysis was performed for the risk factors of AR and ASR. Results The 33.9% patients had AR, and 19.7% patients had ASR. The high sensitive C reactive protein (hsCRP) level in AR+ASR group increased obviously compared with that in AS group(P<0.05).In the patients older than 65 years old,the incidence rate of AR+ASR in high risk patients increased significantly (P<0.05). Logistic regression analysis showed that platelet counts [odd ratio (OR)=0.996,95％ confidence interval (CI): 0.991-0.999,P=0.041] and hs-CRP levels(OR=0.972,95％CI: 0.959-0.996,P=0.014) were risk factors for AR and ASR. Conclusions The incidence rate of AR in patients with acute cerebral infarction may be related to platelet count and inflammation.

Key words: Cerebral infarction, Aspirin resistance, Thrombelastography

中图分类号:

R446.11

邓琳,邱丽君,顾青,王根发. 急性脑梗死患者阿司匹林抵抗危险因素分析[J]. 检验医学, 2013, 28(9): 765-769.

DENG Lin,QIU Lijun,GU Qing,WANG Genfa. Analysis on risk factors for aspirin resistance in patients with acute cerebral infarction[J]. , 2013, 28(9): 765-769.

[1]	畅慧君, 张敏, 张其相. 血清Hcy水平与接受静脉溶栓治疗急性脑梗死患者短期预后的相关性[J]. 检验医学, 2023, 38(11): 1057-1061.
[2]	薛亚泽, 何劲, 唐绍军. 血清miR-150-5p和LTBP-2检测在急性脑梗死患者病情评估中的价值[J]. 检验医学, 2023, 38(11): 1082-1086.
[3]	杨小兰, 胡增军, 王生清, 马淑霞, 曾永杰, 王成磊. 老年急性脑梗死患者肠道部分常见细菌分布及其与认知功能的相关性[J]. 检验医学, 2022, 37(9): 839-843.
[4]	杜宇平, 陈阳. sCD147、sCD40L、miR-21与ACI患者颈动脉粥样斑块类型及预后的关系[J]. 检验医学, 2022, 37(7): 636-640.
[5]	缪颖波, 赵强, 宋颖, 诸佩超, 周维, 徐翀. 血栓弹力图性能规范研究[J]. 检验医学, 2022, 37(7): 680-683.
[6]	喻蕾, 郝新斌, 葛秋颖. 急性脑梗死患者CXCL12、PTX-3、FⅦa/FⅦAg比值与定量脑电图指标的相关性[J]. 检验医学, 2022, 37(2): 194-195.
[7]	谢媛, 易婉婉, 史秋园, 吕中伟, 刘瑾. 血栓弹力图和常规凝血试验评估结肠癌和结肠息肉患者凝血状态的临床价值[J]. 检验医学, 2022, 37(11): 1007-1011.
[8]	苗文佳, 谷昊, 李刚. 血小板最大聚集率和血栓最大振幅在儿童血小板无力症和巨大血小板综合征中的临床应用[J]. 检验医学, 2022, 37(11): 1026-1029.
[9]	孙越红, 张丽敏, 李虓, 王丹, 吴静, 李玉文, 张国军. 血栓弹力图指标与DIC的相关性及其诊断价值分析[J]. 检验医学, 2021, 36(5): 495-499.
[10]	丁宁, 张卫峰, 陈小勇, 赵克温. 平均血小板体积、D-二聚体和纤维蛋白原降解产物与脑梗死及其病变程度的相关性研究[J]. 检验医学, 2021, 36(4): 384-387.
[11]	董雪梅, 叶萍, 张翀, 韩璐, 杜晓钟. 兰州地区健康妊娠妇女血栓弹力图参数参考区间的建立[J]. 检验医学, 2020, 35(8): 795-798.
[12]	苏健, 徐冰, 宋媛, 薛凌. 脑梗死患者血清炎性因子、同型半胱氨酸与颈动脉内膜中层厚度的关系[J]. 检验医学, 2020, 35(8): 852-853.
[13]	王伯玉, 刘玲玲, 张勤, 姚瀚鑫. 血浆凝血酶激活的纤溶抑制物和血清同型半胱氨酸在急性脑梗死中的诊断价值[J]. 检验医学, 2020, 35(7): 673-675.
[14]	马秀清, 贾海菊, 秦惠萍, 马慧英, 杨兴唐, 祁延霞, 李生梅, 王春玮, 贺玉娟. 青海地区急性脑梗死患者IL-6等8项指标的变化[J]. 检验医学, 2019, 34(9): 821-825.
[15]	王青, 乔郑磊, 宋颖. 血栓弹力图室间质量评价方法初探[J]. 检验医学, 2019, 34(9): 855-858.

急性脑梗死患者阿司匹林抵抗危险因素分析

Analysis on risk factors for aspirin resistance in patients with acute cerebral infarction

RichHTML

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics