The Clinical Study Of Aspirin Resistance In Celebral Infarction Patients With Diabetes Mellitus

Objective : The existence of aspirin resistance(AR) impact the prevention and prognosis of patients with cardiovascular and cerebrovascular diseases. Diabetes is recognized as an independent risk factor for cerebral infarction.Studies have pointed out that diabetes is also an independent risk factor for aspirin resistance,which lead to the incidence of cerebral infarction and the recurrence rate is higher than patients without diabetes.To investigate the incidence of AR in cerebral infarction patients with type diabetes,analysis of relevant factors of AR and further investigate the possible mechanisms of AR, pay attention to prevention and treatment of AR, for the early identification, treatment of aspirin to provide a clinical basis for the corresponding resistance. Methods : 166 hospitalized cerebral infarction patients with diabetes between October 2013 and December 2014 were selected in neurology department of Yijishan hospital, Monitoring of the hospitalized patients blood pressure, heart rate, body mass index, blood lipid, improving ECG, blood routine test, hemagglutination,fasting bloodglucose,homocysteine laboratory detection, 2-hr plasma glucose, glycosylated hemoglobin, fasting insulin and other indicators.Asked in detail about risk factors of cerebral vascular diseases.All patients took aspirin 100mg/d at lesat 7days and no other antiplatelet agents.Taking venous blood 3ml, abandoning its former 1ml, extracting two blood samples 0.5ml were added adenosine diphosphate(ADP) and arachidonic acid(AA),taking ADP and AA as inducer.PL-11 of platelet analyzer directly detected the number of platelets in the blood,by comparing the changes of the platelet count gathered before and after to judge the aggregation function of platelets, the results obtained using the most platelet aggregation to represent.Aspirin resistance was defined as a mean aggregation of ≥60% with 50umol/L ADP and ≥60% with 2mg/ml AA,meeting one of the two standards were judged as aspirin semi-resistance(ASR). Then according to the results of platelet aggregation test,comparing the aspirin resistance occurrence rate.Finally, dividing all the patients into aspirin sensitive group(AS) and aspirin resistance group(including aspirin resistance and aspirin semiresistance) according to the results of platelet aggregation.Statistical analysis was performed on two groups of related factors, we can draw the conclusion and analysis of possible mechanisms of aspirin resistance. Results 1.the incidence of AR in cerebral infarction patients with diabetes is 42.77% 2.the incidence of AR is related with women,high blood fat,high blood sugar, increased body mass index, lycosylated hemoglobin, high fasting blood glucose, high HOMA-IR index and smoking in the past(P<0.05) 3.The incidence of AR is not related with drinking,age,hypertension, coronary heart disease, hyperhomocysteinemia,useing statins,previous cerebral(P>0.05) Conclusions 1.Aspirin resistance is a common phenomenon in cerebral infarction patients with diabetes mellitus. 2.Smoking, high blood lipids, body mass index, women, lycosylated hemoglobin, high fasting blood glucose, high HOMA-IR index cerebral infarctio patients more likely to occur AR.