Clinical Feature Of Aspirin Resistance And Its Relationship With Thromboxan B₂ In Patients With Cerebral Infarction

ObjectiveTo investigate the clinical feature of aspirin resistance(AR)and its relationship with thromboxan B2(TXB2)in patients with cerebral infarction. To study the correlation of the phenomenon of aspirin resistance with age,sex,hypertension,diabetes,high cholesterol and other clinical features.To study the incidence of Aspirin resistance in patients with cerebral infarction and the risk factors for aspirin resistance.MethodsThe study was designed in the first hospital affiliated to Soochow University between December 2008 and December 2009. Select a total of 130 hospitalized patients with cerebral infarction.Thirty health people were selected to be control group. Urine and blood samples were colected before and after aspirin intake(100 mg/day,7days)in all patients.After overnightfasting, a urine sample was obtained, urinary thromboxane B2(11-DH-TXB2) were measured by enzyme linked immunosorbent assay (ELISA).All patients were detected platelet aggregation function using adenosine diphosphate and araehidonie aci. At the same time blood samples were collected whereas fasting plasma glucose (FPG), triglycerides, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), C-reactive protein(CRP)and prealbumin were measured by automatic biochemistry analyzer,fibrinogen was measured by automated blood coagulation.At the same time, height, weight,waistline,hip circumference and blood pressure were measured and patients with cerebral infarction were evaluated the neurological function with the National Institutes of Health Stroke Scale (NIHSS) and then the body mass index (BMI) were calculated.While urine and blood samples were collected in control group,These samples were used to detect the platelet aggregation,urinary 11-DH-TXB2 and various biochemical parameters.All statistical analysis were performed using the Statistical Package for Social Science(SPSS for Windows, Version 17.0).Results1. The results of platelet aggregation test The rate of AR was 20.76%,ASR was 14.62%, AR+ASR was 35.38%,AS was 64.62%.2. The urinary 11-DH-TXB2 levels in patients with cerebral infarction were significantly higher than control group(P<0.01). The diference of the levels of the urinary 11-DH-TXB2 before and after taking aspirin between group AS and group ASR was significant(P<0.01).3. The platelet aggregations evaluated by AA and ADP were used as independent variable,Urinary 11-DH-TXB2 was the dependent variable for linear correlation analysis.Urinary 11-DH-TXB2 levels were correlated with both (P<0.01), But urinary TXB2 levels were positively correlated with Platelet aggregation ratio(PAR) evaluated by AA(r=0.434),which were significantly higher than PAR evaluated by ADP (r=0.305).4. The result of the AR on multiple regression analysis:diabetes,female,hypertension,smoking and the recurrent cerebral infarction are the occurrence of risk factors for AR.Conclusions1. The urine 11-DH-TXB2 levels are increased in cerebral infarction patients. Aspirin can reduce the urine 11-DH-TXB2 levels significantly in infarction patients2. AR exists in patients with cerebral infarction actually.3. AR occurrences closely related with female, hyperlipidemia,the recurrent cerebral infarction, diabetes,hypertension,taking ACEI class of antihypertensive drugs,smoking and other factors.4. In laboratory, we can use the platelet aggregation using AA and the urinary 11-DH-TXB2 levels to evaluate of aspirin resistance.