【摘要】 目的探究阿司匹林和氯吡格雷在缺血性脑血管病治疗中的疗效及发生药物抵抗的影响因素。方法连续收集期间在吉林大学第二医院神经内科住院的服用阿司匹林、氯吡格雷或二者合用的急性缺血性卒中患者214例,用药1周后行血栓弹力图检测其抗血小板聚集作用,并分析其抗血小板抵抗可能的影响因素。结果①单用阿司匹林组发生药物抵抗12例(30.0%),双抗治疗组发生阿司匹林抵抗15例(9.3%),二者相比差异有统计学意义;单用氯吡格雷组发生药物抵抗6例(50%),双抗治疗组氯吡格雷发生抵抗48例(29.6%),二者相比差异无统计学意义;对阿司匹林和氯吡格雷同时发生抵抗7例(4.3%);双抗治疗组中泰嘉抵抗14例(34.1%)、波立维抵抗34例(28.1%),二者相比差异无统计学意义。②双抗治疗组中氯吡格雷敏感组和氯吡格雷抵抗组吸烟、男女例数差异有明显统计学差异。结论阿司匹林比氯吡格雷发生药物抵抗率低,阿司匹林与氯吡格雷联合使用可增加抗血小板聚集治疗作用,泰嘉和波立维对血小板的抑制作用无明显差别。吸烟、男性患者发生氯吡格雷抵抗较女性、不吸烟患者发生氯吡格雷抵抗的概率更低。更多还原

【Abstract】 Objective To explore the effect of aspirin and clopidogrel in the treatment of ischemic cerebrovascular disease and the influencing factors of drug resistance.Methods 214 patients with acute ischemic stroke who were hospitalized in the department of neurology of the second hospital of jilin university during the continuous collection period took aspirin,clopidogrel or a combination of the two.Thrombotic elasmogram was conducted 1 week later to detect the anti-platelet aggregation effect of thrombotic elasmogram and analyze the possible influencing factors of its anti-platelet resistance.Results ①There were 12 cases(30.0%)of drug resistance in the aspirin group alone and 15 cases(9.3%)of drug resistance in the dual therapy group.The difference between the two groups was statistically significant.Drug resistance occurred in 6 cases(50%)of the clopidogrel group and 48 cases(29.6%)of the clopidogrel group,and there was no statistical difference between the two groups.Resistance to aspirin and clopidogrel occurred in 7 cases(4.3%).There were 14 cases(34.1%)of taijia resistance and 34 cases(28.1%)of bolivar resistance in the dual-antibody treatment group,and the differences between the two groups were not statistically significant.②There were statistically significant differences in smoking and number of male and female cases between clopidogrel sensitive group and clopidogrel resistant group in the treatment group.Conclusion The drug resistance rate of aspirin is lower than that of clopidogrel,and the combination of aspirin and clopidogrel can increase the therapeutic effect of anti-platelet aggregation,while there is no significant difference in the inhibition effect of teja and bolivar on platelets.The incidence of clopidogrel resistance in smoking and male patients was lower than that in female and non-smoking patients.更多还原