The Study Of Platelet Detections In Diagnosis And Anti-platelet Therapy Of Patients With Ischemic Stroke

Aims:To investigate the effects of two dose regimens of continuous(each day)and intermittent administration(every other day)of aspirin on platelet function in healthy volunteers.Methods:This study included 21 healthy volunteers,10 males(47.6%)and 11 females(52.4%),who were registered the clinical characteristics(age,height,weight and systolic/diastolic pressure)of and randomly divided into two groups:(1)continuous aspirin group:100 mg aspirin each day was administrated for 30 days;(2)intermittent aspirin group:100 mg aspirin each day was administrated for 14 days,followed by 100 mg aspirin every other day for 16 days.Blood samples and clinical data are collected prior to aspirin(baseline)and on 14 day,28 day after aspirin.The measurants of blood lipids(include cholesterol,triglycerides,HDL,LDL),CRP and blood routine examination(includes PLT,RBC,WBC,Hb,HCT,MPV,PDW and IPF)were used to compare the general characteristics of the two groups of subjects.The platelet function,measured by TEG,combined with MPV,PDW,and IPF to evaluate platelet activation and turnover.All detected values were statistically analyzed.Results:All subjects had the same COX-1 genotype(A-842G locus genotypes were AA,and C50T locus genotypes were CC).At baseline,the two groups showed no significant difference in age,BMI,systolic blood pressure,diastolic blood pressure,PLT,RBC,WBC,Hb,HCT,MPV,PDW and IPF(P>0.05).Significant increases(P<0.05)in the percentage inhibition of platelet aggregation(%IPA)of Arachidonic Acid(AA)pathway were observed on day 14(continuous administration group vs intermittent administration group,92.99±9.33%vs 83.70±12.31%)and day 28(continuous administration group vs intermittent administration group,82.59±19.97%vs 81.61±15.79%)after aspirin in both groups,compared with the baseline(continuous administration group vs intermittent administration group,2.18±1.74%vs 11.40±7.48%).No difference was detected in the%IPA at each detected time point between two groups(P>0.05).The levels of PDW in two groups also showed the similar dynamic changes with the%IPA of AA pathway(continuous administration group:the baseline 13.23±1.78%,day 14 16±0.37%,day 28 16.21±0.34%;intermittent administration group:the baseline 13.29±1.73%,day 14 16.20±0.14%,day 28 16.17±0.14).Furthermore,no significant changes of ?,MA,?-Angle,IPF,MPV and PDW were observed at each detected time point in both groups(P>0.05)Conclusions:This study was the first to compare the effects of aspirin continuous and intermittent dosing regimens on platelet function in healthy volunteers,and confirmed that the anti-platelet effect of the aspirin intermittent regimen was as effective as the continuous aspirin dosing regimen.The results of this study may provide a new aspirin treatment strategy for antiplatelet therapy in cardiovascular and cerebrovascular diseasesObjective:To investigate the differences of D-dimer,high sensitivity C-reactive protein(hs-CRP)and platelet parameters in different TOAST classifications of ischemic stroke.Methods:A total of 259 patients with ischemic stroke diagnosed during the period from October 2017 to September 2018 in the General Hospital of Northern Theater were collected as case groups and classified according to TOAST etiology classification.100 healthy subjects in the same period were also collected as the control group.The measurment and statistical analysis of D-dimer,hs-CRP,PLT,PCT,MPV and PDW in the two groups were compared.Results:The case group was divided into five categories according to the TOAST classification:81 cases of LAA type,17 cases of CE type,103 cases of SAO type,4 cases of stroke of SOE type and 54 cases of SUE type.The D-dimer,hs-CRP,PLT,MPV,and PDW levels in the case group have statistically significant differences compared with the control group(|Z|=2.656-5.554,P<0.05).Different TOAST subtypes compared with the control groups the differences of D-dimer,hs-CRP,PDW in four subtypes,PLT in SAO type,PLT,PCT,MPV in CE type were all significant(|Z|=2.208-5.216,P<0.05).Compared in different TOAST subtypes,the D-dimer,PLT and PCT levels in CE and the other three subtypes were significant(|Z|=3.078-4.186,P<0.05),and the differences of D-dimer,hs-CRP were also significant between LAA and SAO(|Z|=2.286,P=0.022;|Z|=2.946,P=0.003).Conclusion:There were significant differences of D-dimer,PLT and PCT levels in CE type and other subtypes.The differences of D-dimer,hs-CRP levels between LAA type and SAO type were also significant.Therefore,the D-dimer,PLT,PCT can be used for clinical early prediction of CE subtypes,and the D-dimer,hs-CRP can be used for early identification of LAA and SAO subtypes.