急性脑梗死患者发生阿司匹林抵抗相关危险因素分析

Analysis of Risk Factors Related to Aspirin Resistance in Patients with Acute Cerebral Infarction

摘要: 目的：探讨急性脑梗死患者发生阿司匹林抵抗与相关危险因素的关系。方法：潍坊益都市中心医院2022年10月至2023年5月急性脑梗死患者共358名，患者于入院当日开始口服阿司匹林肠溶片100 mg/d，服用阿司匹林10 d后，根据血小板聚集实验结果将患者分为阿司匹林抵抗(Aspirin Resistance, AR)组和阿司匹林敏感(Aspirin sensitivity, AS)组，分别就AR组和AS组的血小板内皮聚集受体1 (Platelet-endothelial aggregation receptor 1, PEAR1)基因型的分布情况、高血压、2型糖尿病、性别、年龄、吸烟、饮酒等数据进行收集。结果：与AS组患者比较，AR组患者在性别、高血压、2型糖尿病、吸烟史等方面差异有统计学意义(P < 0.05)；而年龄、饮酒史方面比较，差异无统计学意义(P > 0.05)；AR组PEAR1野生型GG基因频率低于AS组，差异有统计学意义(P < 0.05)；AR组PEAR1纯合突变型AA基因频率高于AS组，差异有统计学意义(P < 0.05)。结论：急性脑梗死患者发生阿司匹林抵抗与患者PEAR1基因的多态性、高血压、2型糖尿病、性别和吸烟等因素有关。

Abstract: Objective: To investigate the relationship between aspirin resistance and related risk factors in pa-tients with acute cerebral infarction. Methods: A total of 358 patients with acute cerebral infarction were diagnosed in Weifang Yidu Central Hospital from October 2022 to May 2023. The patients be-gan to take aspirin enteric-coated tablets 100 mg/d orally on the day of admission, and after taking aspirin for 10 days, according to the platelet aggregation test results, the patients were divided into Aspirin Resistance (AR) group and Aspirin Sensitivity (AS) group. Platelet aggregation receptor 1 (PEAR1) genotype distribution, hypertension, type 2 diabetes, gender, age, smoking, alcohol con-sumption and other data were collected in AR and AS groups. Results: Compared with AS group, AR group had significant differences in gender, hypertension, type 2 diabetes, smoking history and other aspects (P < 0.05). There was no significant difference in age and drinking history (P > 0.05). The frequency of PEAR1 wild type GG gene in AR group was lower than that in AS group, and the difference was statistically significant (P < 0.05); the frequency of PEAR1 homozygous mutant AA gene in AR group was higher than that in AS group, the difference was statistically significant (P < 0.05). Conclusion: The occurrence of aspirin resistance in patients with acute cerebral infarction is related to PEAR1 gene polymorphism, hypertension, type 2 diabetes, sex and smoking.