脑梗死复发患者血小板活化及阿司匹林抵抗研究

目的探讨在脑梗死复发的治疗中血小板向细胞聚集体（PLA）、血小板聚集和阿司匹林抵抗（AR）的重要作用。方法在入院当天对58例复发组脑梗死患者和116例初发组脑梗死患者采用1：2配对法，对其血小板聚集率和PLA水平进行测定。每晚开始顿服拜阿司匹林200mg，连续顿服7～10d后，通过再次测量患者的血小板聚集率，挑选出具有阿司匹林抵抗的患者。结果在入院当天的血小板聚集率测定结果和PLA水平均表现为复发组高于初发组患者，在持续顿服7-10d的拜阿司匹林后，阿司匹林抵抗发生率也表现为复发组高于初发组患者，差异均有统计学意义（P〈0．05）。结论阿司匹林抵抗和血小板活化在脑梗死复发过程中可能起着重要作用，可能是脑梗死复发的重要危险因素之一。因此在脑梗死患者的二级预防中服用阿司匹林期间有必要进行血小板聚集率的检查，尽早发现和识别AR．及时调整二级预防策略。

The study of platelet activation and aspirin resistance in patients with recurrent cerebral infarction

Objective To investigate roles of platelet-leukocyte aggregation,platelet aggregation and aspirin resistance in patients with recurrent cerebral infarction.Methods The platelet aggregation rate and the levels of PLA were performed in 58 patients with recurrent cerebral infarction and 116 patients with the first onset of cerebral infarction on the first day of admission,then aspirin tablets 200 mg were taken by patients every night.The platelet aggregation rate was performed again after 7-10 days,and the patients of aspirin resistance were screened.Results The platelet aggregation rate and the levels of PLA in patients with recurrent cerebral infarction were significantly higher than those of patients with first onset of cerebral infarction.The incidence of aspirin resistance in patients with recurrent cerebral infarction was significantly higher than that of patients with first onset of cerebral infarction(P < 0.05).Conclusion Aspirin resistance and platelet activation may play an important role in the process of recurrence of cerebral infarction,and may be important risk factors for recurrence of cerebral infarction,so it is necessary to check the platelet aggregation rate in patients with cerebral infarction during taking aspirin for the secondary prevention,to find and identify AR earlier,and adjust secondary prevention strategies.