【摘要】：目的探討顱內動脈瘤患者顱內血管支架置入輔助彈簧圈栓塞術后氯吡格雷抵抗(CR)的影響因素。方法收集132例顱內動脈瘤患者的臨床資料。本組患者均采用顱內血管支架置入輔助彈簧圈栓塞治療,術后服用阿司匹林和氯吡格雷雙聯(lián)抗血小板,術后第5天進行血栓彈力圖凝血分析儀檢測二磷酸腺苷(ADP)誘導的血小板聚集抑制率,ADP誘導的血小板聚集抑制率30%為CR。患者按是否存在術后CR分為CR組和對照組,比較兩組基礎臨床資料(年齡、性別、吸煙史、高脂血癥史)及臨床生化檢查結果(血小板計數(shù)、糖化血紅蛋白、空腹血糖、甘油三酯、總膽固醇)。P0.05者行多因素分析確定顱內動脈瘤患者顱內血管支架置入輔助彈簧圈栓塞術后氯吡格雷抵抗(CR)的獨立危險因素。結果術后第5天CR 36例(CR發(fā)生率27.3%,CR組),氯吡格雷敏感96例(對照組)。兩組患者女性構成比、血小板計數(shù)和糖化血紅蛋白水平相比,P均0.05;吸煙、高血壓、高脂血癥構成比及空腹血糖、甘油三酯、總膽固醇水平相比,P均0.05。Logistic回歸分析結果顯示,女性(OR為1.60,95%CI為1.05~3.20)、高糖化血紅蛋白(OR為2.68,95%CI為1.10~5.46)、血小板計數(shù)增高(OR為2.13,95%CI為1.03~4.15)均是顱內動脈瘤患者顱內血管支架置入輔助彈簧圈栓塞術后CR的獨立危險因素,P均0.05。結論女性、高糖化血紅蛋白、血小板計數(shù)增高是顱內動脈瘤患者顱內血管支架置入輔助彈簧圈栓塞術后CR的危險因素。
[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 鹵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.
【作者單位】： 濱州市人民醫(yī)院;
【分類號】：R651.12

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