摘要
目的探讨脑梗死患者服用氯吡格雷后腺苷二磷酸(adenosine diphosphate,ADP)诱导的血小板聚集率水平与脑梗死复发的相关性,为临床抗血小板治疗提供参考。方法本研究为前瞻性队列研究,纳入2021年7月—2022年6月在揭阳市人民医院收治的120例脑梗死患者,接受常规治疗和抗血小板治疗(氯吡格雷75 mg,1次/d),检测治疗后5 d的血小板聚集率,按血小板最大聚集率分为3组,即A组(>55%)、B组(35%~55%)和C组(<35%),分别为35例、46例和39例。通过对患者进行健康教育,提高治疗依从性,并进行为期1年的随访。利用logistic回归分析血小板聚集率与脑梗死复发风险的相关性。结果随访1年后,A组、B组和C组中分别有8例、3例和2例患者发生缺血性脑卒中复发,复发率分别为22.9%、6.5%和5.1%,差异有统计学意义(P<0.05)。A组、B组和C组中分别有1例、2例和3例患者发生出血性脑卒中,出血率分别为2.9%、4.3%和7.7%,差异无统计学意义(P>0.05)。logistic回归分析显示,血小板最大聚集率是脑梗死复发的独立危险因素(OR=3.320,P<0.05)。结论脑梗死患者服用氯吡格雷后,血小板最大聚集率水平与脑梗死复发风险呈正相关,血小板最大聚集率越高,脑梗死复发风险越大。血小板最大聚集率可作为评估氯吡格雷抗血小板治疗效果的指标,为临床个体化治疗提供依据。
Objective To explore the correlation between adenosine diphosphate(ADP)-induced platelet aggregation levels and recurrent stroke in patients with ischemic stroke taking clopidogrel,providing reference for clinical antiplatelet therapy.Methods This prospective cohort study included 120 patients with cerebral infarction admitted to Jieyang People's Hospital from July 2021 to June 2022,who received conventional therapy and antiplatelet therapy(clopidogrel 75 mg,once a day).The platelet aggregation rate 5 days after treatment was detected,and the patients were divided into 3 groups according to the maximum platelet aggregation rate,they were group A(>55%),group B(35%to 55%)and group C(<35%)accouting for 35 cases,46 cases and 39 cases.Health education was given to patients to improve treatment compliance and 1-year follow-up was conducted.The logistic regression was used to analyze the correlation between platelet aggregation rate and the risk of cerebral infarction recurrence.Results After 1 year of follow-up,ischemic stroke recurred in 8 patients in group A,3 patients in group B and 2 patients in group C,with recurrence rates of 22.9%,6.5%and 5.1%,respectively,with statistical significance(P<0.05).In group A,group B and group C,hemorrhagic stroke occurred in 1,2 and 3 patients,with bleeding rates of 2.9%,4.3%and 7.7%,respectively,with no statistical significance(P>0.05).The logistic regression analysis showed that the maximum platelet aggregation rate was an independent risk factor for cerebral infarction recurrence(OR=3.320,P<0.05).Conclusion After ischemic stroke patients take clopidogrel,the level of ADP-induced platelet aggregation is positively correlated with the risk of recurrent stroke.The higher the platelet aggregation rate,the greater the risk of recurrent stroke.Platelet aggregation rate can serve as an indicator to assess the efficacy of clopidogrel antiplatelet therapy,providing a basis for personalized clinical treatment.
作者
卢晓航
黄晓新
陈丹娜
黄杰锋
黄亚珍
蔡典潜
李佳凯
林凯胜
LU Xiaohang;HUANG Xiaoxin;CHEN Danna;HUANG Jiefeng;HUANG Yazhen;CAI Dianqian;LI Jiakai;LIN Kaisheng(Department of Neurology,Jieyang People's Hospital,Jieyang Guangdong 522000,China)
出处
《中国卫生标准管理》
2024年第19期93-96,共4页
China Health Standard Management
基金
揭阳市科学计划项目(ylxm085)。
关键词
脑梗死
氯吡格雷
腺苷二磷酸诱导
血小板聚集率
抗血小板治疗
复发
ischemic stroke
clopidogrel
adenosine diphosphate-induced
platelet aggregation rate
antiplatelet therapy
recurrence
