血管支架置入辅助弹簧圈栓塞术后的颅内动脉瘤患者氯吡格雷抵抗影响因素分析

发布时间：2019-03-20 17:00

【摘要】：目的探讨颅内动脉瘤患者颅内血管支架置入辅助弹簧圈栓塞术后氯吡格雷抵抗(CR)的影响因素。方法收集132例颅内动脉瘤患者的临床资料。本组患者均采用颅内血管支架置入辅助弹簧圈栓塞治疗,术后服用阿司匹林和氯吡格雷双联抗血小板,术后第5天进行血栓弹力图凝血分析仪检测二磷酸腺苷(ADP)诱导的血小板聚集抑制率,ADP诱导的血小板聚集抑制率30%为CR。患者按是否存在术后CR分为CR组和对照组,比较两组基础临床资料(年龄、性别、吸烟史、高脂血症史)及临床生化检查结果(血小板计数、糖化血红蛋白、空腹血糖、甘油三酯、总胆固醇)。P0.05者行多因素分析确定颅内动脉瘤患者颅内血管支架置入辅助弹簧圈栓塞术后氯吡格雷抵抗(CR)的独立危险因素。结果术后第5天CR 36例(CR发生率27.3%,CR组),氯吡格雷敏感96例(对照组)。两组患者女性构成比、血小板计数和糖化血红蛋白水平相比,P均0.05;吸烟、高血压、高脂血症构成比及空腹血糖、甘油三酯、总胆固醇水平相比,P均0.05。Logistic回归分析结果显示,女性(OR为1.60,95%CI为1.05~3.20)、高糖化血红蛋白(OR为2.68,95%CI为1.10~5.46)、血小板计数增高(OR为2.13,95%CI为1.03~4.15)均是颅内动脉瘤患者颅内血管支架置入辅助弹簧圈栓塞术后CR的独立危险因素,P均0.05。结论女性、高糖化血红蛋白、血小板计数增高是颅内动脉瘤患者颅内血管支架置入辅助弹簧圈栓塞术后CR的危险因素。
[Abstract]:Objective to investigate the influencing factors of clopidogrel resistance to (CR) in patients with intracranial aneurysms after placement of stent-assisted coil embolization. Methods the clinical data of 132 patients with intracranial aneurysm were collected. All the patients were treated with intracranial stent placement assisted with coil embolization. After operation, aspirin and clopidogrel were used in combination with antiplatelet therapy. Platelet aggregation inhibition rate induced by adenosine diphosphate (ADP) was detected by thromboelastogram coagulation analyzer on the 5th day after operation. The inhibition rate of platelet aggregation induced by ADP was 30% CR.. The patients were divided into CR group and control group according to the existence of postoperative CR. The basic clinical data (age, sex, smoking history, hyperlipidemia history) and clinical biochemical examination results (platelet count, glycosylated hemoglobin, fasting blood glucose) were compared between the two groups. The independent risk factors of clopidogrel resistance to (CR) in patients with intracranial aneurysms were determined by multivariate analysis. Results CR occurred in 36 cases (27.3%, CR group) and clopidogrel sensitive in 96 cases (control group) on the 5th day after operation. The ratio of female composition, platelet count and glycosylated hemoglobin (HbA1c) in the two groups were 0. 05 (P < 0. 05). Smoking, hypertension, hyperlipidemia and fasting blood glucose, triglyceride, and total cholesterol levels, P-all 0.05.Logistic regression analysis showed that women (OR 1.60,95% CI 1.05-3.20), compared with smoking, hypertension, hyperlipidemia and fasting blood glucose, triglyceride and total cholesterol levels. High glycosylated hemoglobin (OR is 2.68,95% CI is 1.10x5.46), The increased platelet count (OR = 2.13, 95% CI: 1.03 卤4.15) was an independent risk factor for CR after endovascular stent-assisted coil embolization in patients with intracranial aneurysm (P < 0.05). Conclusion female, high glycosylated hemoglobin and increased platelet count are risk factors for CR in patients with intracranial aneurysms after endovascular stent placement assisted coil embolization.
【作者单位】：滨州市人民医院;
【分类号】：R651.12

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