脑梗死患者血小板N-甲基-D-天冬氨酸受体表达与阿司匹林抵抗的相关性研究

目的探讨脑梗死患者血小板N-甲基-D-天冬氨酸(NMDA)受体表达与阿司匹林抵抗(AR)的相关性。方法选择2011年8月—2013年7月在我院神经内科住院的脑梗死患者45例为脑梗死组,同期在我院体检中心体检健康者40例为对照组。脑梗死患者确诊后即开始规律服用阿司匹林(100 mg/d),检测两组受检者NMDA受体表达水平和血小板聚集率。结果对照组受检者NMDA受体相对表达量为(0.11±0.07),低于脑梗死组-治疗前患者的(0.32±0.12)(P0.001),脑梗死组-治疗前患者NMDA受体相对表达量低于脑梗死组-治疗后患者的(0.69±0.15)(P0.001)。对照组受检者血小板聚集率为(32.38±11.38)%,脑梗死组-治疗后患者为(43.81±14.40)%,均低于脑梗死组-治疗前患者的(57.00±18.96)%。Spearman相关分析结果显示,对照组受检者、脑梗死组-治疗前患者、脑梗死组-治疗后患者血小板NMDA受体相对表达量与血小板聚集率均无直线相关性(P0.05)。结论脑梗死患者血小板NMDA受体表达水平升高,阿司匹林可上调脑梗死患者血小板NMDA受体的表达,NMDA受体表达增加可能是脑梗死患者发生AR的重要原因。

Correlation between Expression of N- Methyl- D- Aspartate Receptor of Platelets and Aspirin Resistance in Patients with Cerebral Infarction

Objective To investigate the correlation between expression of N- Methyl- D- aspartate（NMDA） receptor of platelets and aspirin resistance in patients with cerebral infarction. Methods From August 2011 to July 2013,a total of 45 patients with cerebral infarction admitted to Department of Neurology of our hospital were selected as case group,while 40 healthy cases in our hospital were selected as control group. Case group given aspirin（ 100 mg per day） after diagnosed. Expression of NMDA receptor and rate of platelet aggregation of the two groups were detected. Results The relative expression of NMDA receptor of control group was（0. 11 ± 0. 07）,was lower than that of case group of（0. 32 ± 0. 12）（ P〈0. 001） before treatment,while that of case group before treatment was lower than that of case group of（0. 69 ± 0. 15）（ P〈0. 001） after treatment. The rate of platelet aggregation of control group was（32. 38 ± 11. 38）%,that of case group after treatment was（43. 81 ± 14. 40）%,were both lower than that of case group of（57. 00 ± 18. 96）% before treatment. Spearman correlation analysis showed that,the relative expression of NMDA receptor of control group,of case group before or after treatment was not correlated with the rate of platelet aggregation（ P〈0. 05）. Conclusion The expression of NMDA receptor of platelets in patients with cerebral infarctionis ishigher,aspirin can up- regulated its expression,and increasing of NMDA receptor may play an important role in aspirin resistance.