神经损伤与功能重建
神經損傷與功能重建
신경손상여공능중건
NEURAL INJURY AND FUNCTIONAL RECONSTRUCTION
2013年
6期
435-439
,共5页
龚雪琴%杨超%胡继川%王云甫
龔雪琴%楊超%鬍繼川%王雲甫
공설금%양초%호계천%왕운보
急性脑卒中%阿司匹林抵抗%缺血性卒中%死亡率%卒中复发
急性腦卒中%阿司匹林牴抗%缺血性卒中%死亡率%卒中複髮
급성뇌졸중%아사필림저항%결혈성졸중%사망솔%졸중복발
acute stroke%aspirin resistance%ischemic stroke%mortality%stroke recurrence
目的：探讨急性缺血性脑卒中患者中阿司匹林抵抗（AR）的发生率及其与预后的关系。方法：连续入选212例急性缺血性脑卒中患者，入院当天开始服用阿司匹林，7~10 d后检测血小板聚集率，筛选出AR患者（AR组）及阿司匹林敏感AS患者（AS组），并进行3~24个月随访，观察随访期间缺血性卒中的再发以及死亡情况，采用Logistic回归分析AR发生的危险因素及其与死亡率的关系。结果：AR 68例（32.1%），AS 144例（67.9%）；2组一般资料差异无统计学意义；AR组发生缺血性卒中14例（20.6%），全因死亡22例（32.4%）；AS组缺血性卒中19例（13.2%），全因死亡24例（16.7%）；AR组死亡率高于AS组，差异有统计学意义（＝0.010），缺血性卒中复发率差异无统计学意义。AR（=0.027）、NIHSS得分（=0.003）及年龄（=0.029）是急性缺血性卒中患者2年死亡率的独立危险因素。结论：急性缺血性卒中患者中AR发生率高，AR与急性缺血性卒中患者2年死亡率密切相关。
目的：探討急性缺血性腦卒中患者中阿司匹林牴抗（AR）的髮生率及其與預後的關繫。方法：連續入選212例急性缺血性腦卒中患者，入院噹天開始服用阿司匹林，7~10 d後檢測血小闆聚集率，篩選齣AR患者（AR組）及阿司匹林敏感AS患者（AS組），併進行3~24箇月隨訪，觀察隨訪期間缺血性卒中的再髮以及死亡情況，採用Logistic迴歸分析AR髮生的危險因素及其與死亡率的關繫。結果：AR 68例（32.1%），AS 144例（67.9%）；2組一般資料差異無統計學意義；AR組髮生缺血性卒中14例（20.6%），全因死亡22例（32.4%）；AS組缺血性卒中19例（13.2%），全因死亡24例（16.7%）；AR組死亡率高于AS組，差異有統計學意義（＝0.010），缺血性卒中複髮率差異無統計學意義。AR（=0.027）、NIHSS得分（=0.003）及年齡（=0.029）是急性缺血性卒中患者2年死亡率的獨立危險因素。結論：急性缺血性卒中患者中AR髮生率高，AR與急性缺血性卒中患者2年死亡率密切相關。
목적：탐토급성결혈성뇌졸중환자중아사필림저항（AR）적발생솔급기여예후적관계。방법：련속입선212례급성결혈성뇌졸중환자，입원당천개시복용아사필림，7~10 d후검측혈소판취집솔，사선출AR환자（AR조）급아사필림민감AS환자（AS조），병진행3~24개월수방，관찰수방기간결혈성졸중적재발이급사망정황，채용Logistic회귀분석AR발생적위험인소급기여사망솔적관계。결과：AR 68례（32.1%），AS 144례（67.9%）；2조일반자료차이무통계학의의；AR조발생결혈성졸중14례（20.6%），전인사망22례（32.4%）；AS조결혈성졸중19례（13.2%），전인사망24례（16.7%）；AR조사망솔고우AS조，차이유통계학의의（＝0.010），결혈성졸중복발솔차이무통계학의의。AR（=0.027）、NIHSS득분（=0.003）급년령（=0.029）시급성결혈성졸중환자2년사망솔적독립위험인소。결론：급성결혈성졸중환자중AR발생솔고，AR여급성결혈성졸중환자2년사망솔밀절상관。
Objective:To investigate the correlation of aspirin resistance (AR) with prognosis in patients with a-cute ischemic stroke. Methods:Two hundred and twelve patients with acute ischemic stroke were consecutively selected, and aspirin was given from the first day of admission. The platelet aggregation rate was measured after 7~10 days to screen the patients with aspirin resistance or aspirin sensitivity. All patients were followed up for 3 to 24 months and the ischemic stroke recurrence and related death events were recorded. Logistic regression mod-el was used to estimate the risk factors of aspirin resistance and the correlation between aspirin resistance and 2-year mortality. Results out of 212 patients ,68 (32.1%) patients were resistant to aspirin whereas 144 (67.9%) patients were sensitive. There was no significant difference between the two groups in general, risk factors, labo-ratory test results and NIHSS scores ( >0.05). The incidence of all-cause mortality in aspirin resistance group was significant higher than that in aspirin sensitivity group ( =0.01). Logistic regression analysis revealed that the re-currence rate of ischemic stroke (20.6%) of was higher in AR group than that in AS group, but the difference was not significant ( >0.05). Aspirin resistance (OR=3.051,95%CI 1.072-7.895 ,=0.027), NIHSS scores (OR=1. 208,95%CI 1.016-1.439,=0.003), and age (OR=1.143,95%CI 1.078-1.202,=0.029) were independent risk predictors of 2-year mortality in patients with acute ischemic stroke. Conclusion:The incidence of aspirin resis-tance is high in patients with acute ischemic stroke. Aspirin resistance is closely correlated with 2-year mortality in patients with acute ischemic stroke.
