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.