Association Of Aspirin Resistance And Platelet Membrane Glycoproteinâ…¡b HPA-3 Polymorphism And Ischemic Stroke

Objective:In this study,the platelet aggregation rates were checked by flow cytometry in patients with acute cerebral infarction and the control group,to find the aspirin resistance patients.GlycoproteinⅡb HPA-3 polymorphism were determined using the polymerase chain reaction restriction fragment length polymorphism.Follow-up was done for all the patients for a period of 6 months.Explore the correlations between aspirin resistance and platelet membrane glycoproteinⅡb HPA-3 polymorph-ism and the occurrence of cerebral infarction, recurrence and prognosis.Methods:In case group,224 cases of acute cerebral infarction were collected,which was in the Second Hospital affiliated to Tianjin Medical University,from 2012 May to2014 April, including 162 cases of first-episode patients with cerebral infarction, 62 cases of recurrent patients.98 subjects was in control group.The platelet aggregation rates were checked by flow cytometry.In cerebral infarction group,patients taking aspirin 100 mg erverday,retested rates of platelet aggregation,and found the patients with aspirin resistance.It is called aspirin resistance,with adenosine diphosphate as inducer of platelet aggregation rate(%)≥39.27, in the time,arachidonic acid as inducer of platelet aggregation rate(%)≥34.27.It is called aspirin semi-resistance,with adenosine diphosphate as inducer of platelet aggregation rate(%)≥39.27 or arachidonic acid as inducer of platelet aggregation rate(%)≥34.27.Detected glycoprotein Ⅱb HPA-3polymorphismof all people by polymerase chain reaction restriction fragment length polymorphism method,and compared the relationship between the frequency distribution of the genotypes and alleles and cerebral infarction.The patients of ischemic stroke was classified according to Trial of Org 10172 in Acute Stroke Treatment.Follow-up was done for all the patients for a period of 6 months.The patients were classified into two groups of poor clinical outcome and good clinical outcome.The poor clinical outcome was identified to have a score of more than 2 on modified Rankin Scale from stroke onset.Results:The rate of aspirin resisrance in acute cerebral infarction was15.18%,with27.42% in recurrent group.The rate of aspirin semi-resistance in acute cerebral infarction was 29.02%,with 40.32% in recurrent group.The rate of aspirin resistance and aspirin semi-resistancen in recurrent group were higher than those in first group(c2AR=9.977,PAR=0.002;c2ASR=5.319,PASR=0.021).In ischemic stroke group,history of hypertention and diabetes,systolic blood pressure,low density lipoprotein levels,bb genotype and b allele frequencys were higher than those in control group.Logistic regression analysis showed that,hypertension,systolic blood pressure,low density lipoprotein cholesterol,aspirin resistance and bb genotype were independent risk factors for ischemic stroke.In recurrent cerebral infarction group,admission score of national institutes of health stroke scale, history of diabetes,bb genotype and b allele frequency were significantly higher than those in the first group.Logistic regression analysis showed that,history of diabetes,aspirin resistance and bb genotype were independent risk factors of the recurrence of cerebral infarction.In aspirin resistance group,bb genotype and b allele frequencys were higher than those in not aspirin resistance group(cbb2=7.180,Pbb=0.028;cb2=8.422,Pb=0.004).In the poor outcome group,the baseline score of national institutes of health stroke scale, the constituent ratio in large artery atherosclerosis,aspirin resistance,bb genotype and b allele frequency were significantly higher than those in the good outcome group. Logistic regression analysis showed that,age,large artery atherosclerosis subtype,aspirin resistance and bb genotype were the independent risk factors of ischemic stroke in patients with a poor outcome.Conclusion:Aspirin resistance and bb genotype genotype may be independent risk factors for the occurrence of cerebral infarction, recurrence and prognosis, in order to guide individualized antiplatelet prevention and treatment schemes.