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目的观察阿司匹林抵抗(aspirin resistance,AR)对大动脉粥样硬化性脑梗死(large artery atherosclerosis cerebral infarction,LAACI)复发的影响。方法选择阳东县人民医院首次发生LAACI患者269例,入院后即服用阿司匹林200mg,在7~10d后利用比浊法检测血小板聚集率,分为AR组40例,阿司匹林敏感组(aspirin sensitivity,AS)229例,进行随访6~12个月;根据脑梗塞复发的情况分为大动脉粥样硬化复发(large artery atherosclerosis recurrence,LAAR)组38例和大动脉粥样硬化无复发(not large artery atherosclerosis recurrence,NLAAR)组231例,观察AR患者的危险因素,同时观察LAAR与AR之间的关系。结果单因素分析中AR组的LAAR显著高于AS组(34.2%vs 11.7%,P=0.000),跟NLAAR组比较LAAR组患糖尿病、AR、年龄较大的比例均明显升高(P<0.05或0.01);多因素分析中LAAR与AR明显相关(OR=4.692,95%CI=1.052~15.675,P=0.005)。结论AR是LAAR的独立危险因素,能够增加LAAR的风险。
Objective To observe the effect of aspirin resistance (AR) on the recurrence of large artery atherosclerosis cerebral infarction (LAACI). Methods 269 LAACI patients were selected for the first time in Yangdong People’s Hospital. After admission, 200 mg of aspirin was taken. Platelet aggregation was measured by turbidimetry after 7 ~ 10 days. The patients were divided into AR group (n = 40), aspirin sensitivity group ), 229 cases were followed up for 6 to 12 months. According to the recurrence of cerebral infarction, there were 38 cases with large artery atherosclerosis recurrence (LAAR) and 38 cases with no large artery atherosclerosis recurrence NLAAR group of 231 cases, AR patients were observed risk factors, while observing the relationship between LAAR and AR. Results In the univariate analysis, LAAR in AR group was significantly higher than that in AS group (34.2% vs 11.7%, P = 0.000). Compared with NLAAR group, LAAR group had significantly increased diabetes, AR, and age (P <0.05) Or 0.01). LAAR was significantly associated with AR in multivariate analysis (OR = 4.692, 95% CI = 1.052 ~ 15.675, P = 0.005). Conclusion AR is an independent risk factor for LAAR and can increase the risk of LAAR.