急性脑梗死患者发生阿司匹林抵抗的危险因素

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%...

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Bibliographic Details
Published in山东医药 Vol. 56; no. 15; pp. 62 - 64
Main Author 张仕娟 宋玉宁 李乃坤 孙锡波 李炳选
Format Magazine Article
LanguageChinese
Published 潍坊医学院附属益都中心医院,山东青州,262500 2016
Subjects
微小RNA-19a
急性脑梗死
阿司匹林抵抗
阿司匹林抵抗
微小RNA-19a
micro RNA-19a
急性脑梗死
aspirin resistance
acute cerebral infarction
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Summary: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。
Bibliography:Objective To investigate the risk factors for aspirin resistance （ AR） in patients with acute cerebral in-farction. Methods Totally 162 cases of patients with acute cerebral infarction received aspirin enteric-coated tablets 100 mg/d at the beginning of the day of admission. After taking aspirin 10 d, all patients were divided into the AR group （49 cases） and non-AR group （113 cases） according to the results of platelet aggregation test. The clinical data of patients were collected. The expression of microRNA-19a （miR-19a） in the platelets was detected by real-time fluorescence quanti-tative PCR. The influencing factors for the occurrence of AR were analyzed by Logistic regression analysis. The predictive value of expression of miR-19a in platelet for AR was analyzed by using receiver operating characteristic curve （ ROC curve）. Results The expression level of miR-19a in the AR group was 0. 78 ± 0. 09, the type 2 diabetes were found in 26 cases （53. 1%）, while in the non-AR group, the expression level of miR-
ISSN:1002-266X
DOI:10.3969/j.issn.1002-266X.2016.15.022