脑梗死复发患者血小板活化及阿司匹林抵抗研究(1)
[摘要] 目的 探讨在脑梗死复发的治疗中血小板白细胞聚集体(PLA)、血小板聚集和阿司匹林抵抗(AR)的重要作用。 方法 在入院当天对58例复发组脑梗死患者和116例初发组脑梗死患者采用1∶2配对法，对其血小板聚集率和PLA水平进行测定。每晚开始顿服拜阿司匹林200 mg，连续顿服7～10 d后，通过再次测量患者的血小板聚集率，挑选出具有阿司匹林抵抗的患者。 结果 在入院当天的血小板聚集率测定结果和PLA水平均表现为复发组高于初发组患者，在持续顿服7～10 d的拜阿司匹林后，阿司匹林抵抗发生率也表现为复发组高于初发组患者，差异均有统计学意义(P < 0.05)。 结论 阿司匹林抵抗和血小板活化在脑梗死复发过程中可能起着重要作用，可能是脑梗死复发的重要危险因素之一。因此在脑梗死患者的二级预防中服用阿司匹林期间有必要进行血小板聚集率的检查，尽早发现和识别AR，及时调整二级预防策略。
[关键词] 阿司匹林抵抗；血小板活化；血小板白细胞聚集体；脑梗死；复发
[中图分类号] R743.3[文献标识码] B[文章编号] 1673-9701(2012)10-0053-03
, 百拇医药
The study of platelet activation and aspirin resistance in patients with recurrent cerebral infarction
PAN Xiaoyun1 YI Xingyang2 CHI Lifen2 PAN Jibao3
1.Department of Internal Medicine, Ruian Hospital of Traditional Chinese Medicine, Ruian 325200, China; 2.Department of Neurology, Ruian People’s Hospital, Ruian 325200, China; 3.Department of Laboratory, Ruian People’s Hospital, Ruian 325200, China
, 百拇医药
[Abstract] Objective To investigate roles of platelet-leukocyte aggregation, platelet aggregation and aspirin resistance in patients with recurrent cerebral infarction. Methods The platelet aggregation rate and the levels of PLA were performed in 58 patients with recurrent cerebral infarction and 116 patients with the first onset of cerebral infarction on the first day of admission, then aspirin tablets 200 mg were taken by patients every night. The platelet aggregation rate was performed again after 7-10 days, and the patients of aspirin resistance were screened. Results The platelet aggregation rate and the levels of PLA in patients with recurrent cerebral infarction were significantly higher than those of patients with first onset of cerebral infarction. The incidence of aspirin resistance in patients with recurrent cerebral infarction was significantly higher than that of patients with first onset of cerebral infarction (P < 0.05). Conclusion Aspirin resistance and platelet activation may play an important role in the process of recurrence of cerebral infarction, and may be important risk factors for recurrence of cerebral infarction, so it is necessary to check the platelet aggregation rate in patients with cerebral infarction during taking aspirin for the secondary prevention, to find and identify AR earlier, and adjust secondary prevention strategies.
, 百拇医药
[Key words] Aspirin resistance; Activation of platelet; Platelet-leukocyte aggregation; Cerebral infarction; Recurrence
脑梗死是一种发病率、致残率很高的疾病，严重影响人类健康并且复发率高，每年约有4%～14%患者复发，早期复发率达30%，脑梗死复发者预后往往不良。作为一种有效的抗血小板聚集药，阿司匹林广泛应用于心脑血管事件的二级预防及某些经过选择的患者的一级预防，但长期服用仍有可能发生动脉血栓形成事件。本文采用1∶2配对方法，对入住我院及瑞安市人民医院的58例复发脑梗死患者和116例初发脑梗死患者的血小板聚集、血小板白细胞聚集体(PLA)进行检测，从实验室中探讨血小板活化和阿司匹林抵抗在脑梗死复发中的重要作用。
1资料与方法
1.1 研究对象
1.1.1 复发脑梗死组因再次发生脑梗死在48 h内入住我院及瑞安市人民医院的患者。入选标准：①既往有脑梗死病史；②新出现神经功能缺损症状；③初发症状、体征加重，且排除进展性卒中；④上述情况均经头颅CT或MRI证实。排除标准：①心源性脑栓塞患者；②近1周内使用过氯吡格雷、传统非甾体抗炎药(除阿司匹林以外)、华法令、低分子肝素等影响血小板聚集功能的药物；③有出血疾病史，包括家族或个人；④短期内有严重外伤或者进行较大外科手术的患者；⑤血小板计数<100×109/L或>450×109/L的患者；⑥患有骨髓增生异常综合征的患者。经筛选后共有58例患者入选，其中男36例，女22例，年龄43～88岁，平均(73.64±8.54)岁。有51例患者为复发1次，7例患者为复发2次及以上。, 百拇医药(潘小云 易兴阳 池丽芬 潘继豹)
[关键词] 阿司匹林抵抗；血小板活化；血小板白细胞聚集体；脑梗死；复发
[中图分类号] R743.3[文献标识码] B[文章编号] 1673-9701(2012)10-0053-03
, 百拇医药
The study of platelet activation and aspirin resistance in patients with recurrent cerebral infarction
PAN Xiaoyun1 YI Xingyang2 CHI Lifen2 PAN Jibao3
1.Department of Internal Medicine, Ruian Hospital of Traditional Chinese Medicine, Ruian 325200, China; 2.Department of Neurology, Ruian People’s Hospital, Ruian 325200, China; 3.Department of Laboratory, Ruian People’s Hospital, Ruian 325200, China
, 百拇医药
[Abstract] Objective To investigate roles of platelet-leukocyte aggregation, platelet aggregation and aspirin resistance in patients with recurrent cerebral infarction. Methods The platelet aggregation rate and the levels of PLA were performed in 58 patients with recurrent cerebral infarction and 116 patients with the first onset of cerebral infarction on the first day of admission, then aspirin tablets 200 mg were taken by patients every night. The platelet aggregation rate was performed again after 7-10 days, and the patients of aspirin resistance were screened. Results The platelet aggregation rate and the levels of PLA in patients with recurrent cerebral infarction were significantly higher than those of patients with first onset of cerebral infarction. The incidence of aspirin resistance in patients with recurrent cerebral infarction was significantly higher than that of patients with first onset of cerebral infarction (P < 0.05). Conclusion Aspirin resistance and platelet activation may play an important role in the process of recurrence of cerebral infarction, and may be important risk factors for recurrence of cerebral infarction, so it is necessary to check the platelet aggregation rate in patients with cerebral infarction during taking aspirin for the secondary prevention, to find and identify AR earlier, and adjust secondary prevention strategies.
, 百拇医药
[Key words] Aspirin resistance; Activation of platelet; Platelet-leukocyte aggregation; Cerebral infarction; Recurrence
脑梗死是一种发病率、致残率很高的疾病，严重影响人类健康并且复发率高，每年约有4%～14%患者复发，早期复发率达30%，脑梗死复发者预后往往不良。作为一种有效的抗血小板聚集药，阿司匹林广泛应用于心脑血管事件的二级预防及某些经过选择的患者的一级预防，但长期服用仍有可能发生动脉血栓形成事件。本文采用1∶2配对方法，对入住我院及瑞安市人民医院的58例复发脑梗死患者和116例初发脑梗死患者的血小板聚集、血小板白细胞聚集体(PLA)进行检测，从实验室中探讨血小板活化和阿司匹林抵抗在脑梗死复发中的重要作用。
1资料与方法
1.1 研究对象
1.1.1 复发脑梗死组因再次发生脑梗死在48 h内入住我院及瑞安市人民医院的患者。入选标准：①既往有脑梗死病史；②新出现神经功能缺损症状；③初发症状、体征加重，且排除进展性卒中；④上述情况均经头颅CT或MRI证实。排除标准：①心源性脑栓塞患者；②近1周内使用过氯吡格雷、传统非甾体抗炎药(除阿司匹林以外)、华法令、低分子肝素等影响血小板聚集功能的药物；③有出血疾病史，包括家族或个人；④短期内有严重外伤或者进行较大外科手术的患者；⑤血小板计数<100×109/L或>450×109/L的患者；⑥患有骨髓增生异常综合征的患者。经筛选后共有58例患者入选，其中男36例，女22例，年龄43～88岁，平均(73.64±8.54)岁。有51例患者为复发1次，7例患者为复发2次及以上。, 百拇医药(潘小云 易兴阳 池丽芬 潘继豹)