摘要
目的研究脑梗死复发与阿司匹林抵抗(aspirin resistance,AR)及中医体质的相关性。方法 413例脑梗死患者在常规治疗同时连续服用阿司匹林肠溶片100 mg/d,每周至少服用5天,随访时间为12个月。运用比浊法测定阿司匹林敏感性,比较不同阿司匹林敏感性患者中医体质情况,比较不同中医体质AR及阿司匹林敏感(aspirin sensitive,AS)患者脑梗死复发的所占比例。采用PCR法检测所有患者血小板膜糖蛋白(GP)Ⅱb HPA-3基因多态性,运用Logistic回归方法分析脑梗死复发与AR、bb基因型以及体质×阿司匹林敏感性的相关性。结果随访总共11例患者脱落。脑梗死复发患者101例(25.12%),脑梗死无复发患者301例(74.88%)。AR患者152例(37.81%),AS患者250例(62.19%)。脑梗死无复发患者中AR及AS所占比例为26.6%(80/301)、73.4%(221/301),脑梗死复发患者为71.3%(72/101)、28.7%(29/101),比较差异有统计学意义(x^2=64.287,P=0.000)。AR患者中阴虚质所占比例最大[28.3%(43/152)],AS患者中血瘀质所占比例最大[23.6%(59/250)],AR与AS患者的中医体质构成不同,差异有统计学意义(x^2=21.574,P<0.01)。AR患者脑梗死复发率前4位为阴虚质、血瘀质、痰湿质、气虚质,阴虚质最高为22.4%(34门52),AS患者脑梗死复发率前4位为血瘀质、气虚质、痰湿质、湿热质,血瘀质最高为3.2%(2/250)。与脑梗死无复发患者及AS患者比较,脑梗死复发患者及AR患者均bb基因型出现的频率高,而aa、ab基因型出现的频率明显低(x^2=20.171,x^2=55.139,P<0.01)。AR及bb基因型与脑梗死复发呈正相关(OR=18.423,P=0.000;OR=1.304,P=0.028);体质与阿司匹林敏感性存在交互作用(O尺=0.707,P=0.000)。结论脑梗死复发与AR及体质类型有密切关系,AR患者阴虚质脑梗死复发率高,GPⅡb HPA-3基因bb基因型可能是AR及脑梗死复发的危险因素。
Objective To explore the correlation between the recurrence of cerebral infarction and aspirin resistance（AR）/Chinese medical（CM） constitutions.Methods Totally 413 cerebral infarction patients took Aspirin Enteric-coated Tablet（100 mg per day） while receiving routine therapy,5 days at least in a week.They were followed-up for 12 months.Aspirin sensitivity（AS） was determined using turbidimetry.CM constitutions among patients with different AS were compared.Ratios of AR patients and AS patients of different CM constitutions in cerebral infarction recurrent patients were compared.Platelet membrane glycoproteins（GP） Ⅱ b HPA-3 gene polymorphism was detected by polymerase chain reaction（PCR） method.Correlation between recurrence of cerebral infarction and AR,bb genotypes,CM constitutions times AS were analyzed by Logistic regression.Results Totally 11 patients dropped out,101（25.12%）with recurrent cerebral infarction and 301（74.88%）without recurrent cerebral infarction.There were 152（37.81%） AR patients and 250（62.19%） AS patients.AR accounted for 26.6%（80/301） and AS accounted for 73.4%（221/301） in non-recurrent cerebral infarction patients.AR accounted for 71.3%（72/101） and AS accounted for 28.7%（29/101） in recurrent cerebral infarction patients.There was statistical difference in AR and AS ratios（x2=64.287,P =0.000）.The proportion of yin deficiency constitution（YDC） was the largest[28.3%（43/152）]in AR patients.The proportion of blood stasis constitution（BSC） was the largest[23.6%（59/250）]in AS patients.There was statistical difference in CM constitutions between AR patients and AS patients（x2=21.574,P〈0.01）.The former 4 recurrent rates occurred in AR patients of YDC,BSC,damp-phlegm constitution（DPC）,qi deficiency constitution（QDC）.YDC occupied the first place[22.4%（34/152）].The former4 recurrent rates occurred in AS patients of BSC,QDC,DPC,damp-heat constitution（DHC）.BSC occupied the first place[3.2%（2/250）].Compa
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2015年第10期1205-1209,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
山东省中医药科技发展计划重点专科项目(No.2013ZDZK-056)
山东省中医药科技发展计划普通项目(No.2009119)
山东省中医药科技发展计划重点项目(No.2013Z003-4)
关键词
脑梗死复发
阿司匹林抵抗
中医体质
相关性
recurrence of cerebral infarction
aspirin resistance
Chinese medical constitution
corre-lation
