急性脑梗死患者发生阿司匹林抵抗的危险因素

发布时间：2018-05-28 13:52

本文选题：急性脑梗死 + 阿司匹林抵抗　；参考：《山东医药》2016年15期

【摘要】：目的探讨急性脑梗死患者发生阿司匹林抵抗(AR)的危险因素。方法 162例急性脑梗死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(AR)者(AR组,49例)和非AR者(非AR组,113例),收集患者一般临床资料,采用实时荧光定量PCR检测血小板中微小RNA-19a(miR-19a),利用多因素Logistic回归分析法分析影响AR发生的影响因素,利用受试者工作特征曲线(ROC曲线)评估血小板miR-19a表达量预测AR的价值。结果 AR组血小板miR-19a表达量为0.78±0.09、2型糖尿病26例(53.1%),非AR组血小板miR-19a表达量为0.59±0.11、2型糖尿病34例(30.1%),两组比较,P均0.05。多因素Logistic回归分析显示,血小板miR-19a表达量升高是影响急性脑梗死患者发生AR的独立危险因素(OR=4.82,95%CI:1.374~15.835)。ROC曲线分析显示,当miR-19a截断值为0.69时,ROC曲线下面积为0.927(95%CI:0.888~0.966),诊断急性脑梗死的灵敏度为93.9%、特异度为82.3%。结论急性脑梗死AR患者血小板miR-19a表达升高,是AR发生的独立危险因素,可作为预测急性脑梗死发生AR的指标。
[Abstract]:Objective to investigate the risk factors of aspirin resistance to ARA in patients with acute cerebral infarction. Methods 162 patients with acute cerebral infarction were treated with aspirin enteric-coated tablets (100 mg / d) for 10 days. According to the results of platelet aggregation test, the patients were divided into two groups: 49 patients with AR and 49 patients with AR and 113 patients without AR. The general clinical data of the patients were collected. Real time fluorescence quantitative PCR was used to detect microRNA-19a miR-19aI in platelets. The influencing factors of AR were analyzed by multivariate Logistic regression analysis, and the value of predicting AR by miR-19a expression in platelets was evaluated by using the operating characteristic curve (ROC curve). Results the platelet miR-19a expression was 0.78 卤0.09 in AR group and 0.59 卤0.11 in non-AR group in 26 patients with type 2 diabetes mellitus. The expression of platelet miR-19a in non-AR group was 0.59 卤0.11 in 34 patients with type 2 diabetes mellitus. Multivariate Logistic regression analysis showed that increased platelet miR-19a expression was an independent risk factor for AR in patients with acute cerebral infarction. When the miR-19a truncation value was 0.69, the area under the curve was 0.927 ~ 95%, and the sensitivity was 93.9 and the specificity was 82.3% for the diagnosis of acute cerebral infarction. Conclusion the increased expression of platelet miR-19a in AR patients with acute cerebral infarction is an independent risk factor for the occurrence of AR and can be used as a predictor of AR in patients with acute cerebral infarction.
【作者单位】：潍坊医学院附属益都中心医院;
【基金】：潍坊市科技局科研课题资助项目(2015ws109)
【分类号】：R743.3

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