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目的观察北方汉族人群缺血性脑卒中及短暂性脑缺血发作(TIA)患者氯吡格雷抵抗的发生率,并分析可能相关的影响因素。方法共入选104例接受氯吡格雷75 mg·d-1治疗的动脉粥样硬化性脑梗死及TIA患者,于治疗前及治疗后第7天,应用比浊法检测腺苷二磷酸诱导的血小板聚集率。以血小板聚集率下降≤10%为划界,分为氯吡格雷抵抗(CR)组37例(35.58%)和非氯吡格雷抵抗(NCR)组67例(64.42%)。采集两组患者的病史及临床资料,进行统计学分析。结果 CR组合并2型糖尿病和高血压病的患病率高于NCR组(分别P=0.024,P=0.008);CR组血清胆固醇水平和体重指数(BMI)高于NCR组(分别P=0.040,P=0.013)。多因素Logistic回归分析提示BMI≥28 kg/m2与氯吡格雷抵抗可能具有相关性(OR=3.600,95%CI:1.110~11.678,P=0.033)。结论 BMI≥28 kg/m2可能为缺血性脑卒中及TIA患者发生氯吡格雷抵抗的危险因素
Objective To investigate the incidence of clopidogrel resistance in ischemic stroke and transient ischemic attack (TIA) in northern Chinese Han population and to analyze the possible influencing factors. Methods A total of 104 patients with atherosclerotic cerebral infarction and TIA treated with clopidogrel 75 mg · d-1 were enrolled in this study. Before and 7 days after the treatment, adenosine diphosphate-induced platelet Aggregation rate. Thirty patients (35.58%) with clopidogrel resistance (CR) and 67 patients (64.42%) with non-clopidogrel resistance (NCR) were divided by the reduction of platelet aggregation rate ≤10%. Collect the two groups of patients history and clinical data for statistical analysis. Results The prevalence of type 2 diabetes mellitus and hypertension in CR group was significantly higher than that in NCR group (P = 0.024, P = 0.008, respectively). Serum cholesterol and body mass index (BMI) in CR group were significantly higher than those in NCR group , P = 0.013). Multivariate logistic regression analysis suggested that BMI≥28 kg / m2 may be related to clopidogrel resistance (OR = 3.600, 95% CI: 1.110 ~ 11.678, P = 0.033). Conclusions BMI≥28 kg / m2 may be the risk factors of clopidogrel resistance in ischemic stroke and TIA patients