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Predictive value on early neurological deterioration in patients with acute cerebral infarction by detection of aspirin resistance combined with platelet-leukocyte aggregates
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Zheng Ying, Lei Xiao-feng, Cheng Yan, Li Zhi-gang
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Department of Emergency, Tianjin Fourth Central Hospital, Tianjin 300140, China
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Abstract Objective To explore the predictive value on early neurological deterioration (END) in patients with acute cerebral infarction (ACI) by detection of aspirin resistance (AR) combined with platelet-leukocyte aggregates (PLA), to provide reference for END′s early recognition and clinical intervention. Methods 197 cases with ACI were selected, and were all given AR and PLA detection on admission, nerve function were evaluated by NIHSS on admission and 24, 48, 72 h after admission, the occurrence of END were recorded, and were divided into END group and non-END group. Single factor analysis and multiple factor Logistic regression analysis were analyzed on possible related factors in two groups. Results Among 197 patients with ACI, 49 cases occurred END, and the END rate was 24.87%. According to GUM′s criteria for AR, there were 23 cases with AR, 15 cases with ASR and 11 cases with AS in END group, and 17 cases with AR, 29 cases with ASR and 102 cases with AS in non-END group. Single factor analysis showed that, rates or level of AR, ASR and PLA, PMA, PNA, PLyA in END group were all higher than those in non-END group (P<0.05 or P<0.01). Multivariate Logistic regression analysis showed that, AR and PLA, PMA, PNA, PLyA were all independent risk factors of END. For patients with AR and higher level of PLA, PMA, PNA and PLyA, risk of occurring END were higher (P<0.05). Conclusion AR and platelet activation are important risk factors for patients with ACI to occur END, and it may has positive clinical significance to predict END by detection of AR and PLA, and it may reduce the incidence of END by timely adjusting anti-platelet strategies according to detection of AR and PLA.
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Received: 25 December 2017
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About author:: Zheng Ying, E-mail:xieds357@163.com |
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[1]崔颖,佟旭,王伊龙,等. 急性缺血性卒中患者阿替普酶静脉溶栓后发生早期神经功能恶化的危险因素分析[J]. 中华神经科杂志, 2016, 49(12):925-931.[2]荆鹿超,孙瑞红. 阿司匹林抵抗机制的研究[J]. 脑与神经疾病杂志, 2017, 25(10):657-660.
[3]张浩文,柴营营,陈寒昱,等. 阿司匹林抵抗机制研究进展[J]. 中国药科大学学报, 2014, 45(4):496-503.
[4]Bugnicourt JM, Roussel B, Garcia PY, et al. Aspirin non-responder status and early neurological deterioration: a prospective study[J]. Clin Neurol Neurosurg, 2011, 113(3):196-201.
[5]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4):246-257.
[6]Gum PA, Kottke-Marchant K, Poggio ED, et al. Profile and prevalence of aspirin resistance in patients with cardiovascular disease[J]. Am J Cardiol, 2001, 88(3):230-235.[7]李瑞英,陈会生. 急性缺血性脑卒中早期神经功能恶化研究现状及进展[J]. 临床军医杂志, 2017, 45(2):136-139.
[8]涂艳阳,付建芳,付菊芳,等. ABCD2评分预测短暂性脑缺血发作脑卒中风险的回顾分析[J].中国急救医学, 2011, 31(3):203-205.
[9]刘远智,黄春秀. 急性脑梗死患者血小板活化状态及参数的变化及临床意义[J]. 实用医学杂志, 2011, 27(9):1673-1675.
[10]Htun P, Fateh-Moghadam S, Tomandl B, et al. Course of platelet activation and platelet-leukocyte interaction in cerebrovascular ischemia[J]. Stroke, 2006, 37(9):2283-2287.
[11]谭金习,董梅,任法新,等. 血小板-白细胞聚集体促进心肌无复流发生的研究进展[J]. 中国介入心脏病学杂志, 2015, 23(1):37-39.
[12]刘雪淳,王兵,王淑娟,等. 大黄鞣质对肽聚糖诱导血小板凋亡的影响[J]. 中国急救医学, 2016, 36(3):272-276,封3.
[13]Klionsky DJ, Abdelmohsen K, Abe A, et al. Guidelines for the use and interpretation of assays for monitoring autophagy(3rd edition)[J]. Autophagy, 2016, 12(1):1-222.[14]Alba, Aurelie, du Boullay, et al. Direct ring-opening of lactide with amines: application to the organo-catalyzed preparation of amide end-capped PLA and to the removal of residual lactide from PLA samples[J]. Polymer chemistry, 2015, 21(6):989-997.〖JP〗
[15]Zheng AS, Churilov L, Colley RE, et al. Association of aspirin resistance with increased stroke severity and infarct size[J]. JAMA Neurol, 2013, 70(2):208-213.
[16]王建丽,张涌,朱媛媛,等. 急性脑梗死患者阿司匹林抵抗与血小板miR126的相关性[J]. 山东大学学报(医学版), 2014, 59(5):77-81.
[17]马争飞,钟平,张雷,等. 急性脑梗死患者阿司匹林抵抗及相关因素分析[J]. 脑与神经疾病杂志, 2015, 23(4):253-255.
[18]张仕娟,宋玉宁,李乃坤,等. 急性脑梗死患者发生阿司匹林抵抗的危险因素[J]. 山东医药, 2016, 56(15):62-64.
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