Relationship Between Aspirin Resistance And Intestinal Flora In Patients With Cerebral Infarction Complicated With Diabetes Mellitus

Objective:In this study,the difference between aspirin resistance and intestinal flora in patients with cerebral infarction was investigated by comparing whether there was a relationship between the changes of intestinal flora in patients with cerebral infarction complicated with diabetes and the changes of intestinal flora in patients with aspirin resistance,thus providing new research evidence for the mechanism of aspirin resistance.Method:(1)From September 2019 to 2021,53 patients with acute cerebral infarction who were hospitalized in the third district of Department of Neurology,affiliated Hospital of Hebei University,were included.Among them,32 cases were in the simple cerebral infarction group and 21 cases in the cerebral infarction complicated with diabetes group.(2)Give aspirin 200 mg orally and other routine treatments during hospitalization.The age,sex,past medical history,smoking and drinking history,eating habits and HIHSS scores of the objects were collected after admission,and further Completed the examination: blood lipids,glycosylated hemoglobin,blood homocysteine and head CT and nuclear magnetic resonance examination.(3)Fasting venous blood was extracted and centrifuged in the early morning of the next day to test the standard of IL-6.During the period,feces were collected to detect the intestinal flora by 16 S macro gene sequencing method.After 7 days the routine tests of Elastogram + AA were completed,and the dietary survey of the patients was completed.(4)All data were analyzed by SPSS R26.0.0.0 Version calculation,independent sample t test was used to compare the differences of baseline measurement data and intestinal flora between the two groups,chi square test was used to compare the differences of baseline measurement data and aspirin resistance between the two groups,logistic regression analysis was used for multivariate analysis,linear regression analysis was used for correlation,P < 0.05 was regarded as significant statistical difference.Results:⑴In DM group and NDM group,we found that there was no significant difference in aspirin resistance between the two groups.According to the analysis of intestinal microflora of the two groups of objects,it was found that the abundance of core bacteria:Bacteroides,abundance of conditional pathogens: Bacteroides caccae,Bacteroides vulgatus,abundance of probiotics: Bacteroides uniformis were significantly increased in DM group,while only abundance of Bifidobacterium adolescentis was significantly increased in NDM group.⑵In AR group and NAR group,we found that abundance of Clostridium and Ruminococcus were significantly increased in AR group,but there was no significant difference in probiotics and conditional pathogens between the two groups.Conclusion:Our study found that there was no significant difference in aspirin resistance between cerebral infarction patients with diabetes mellitus and cerebral infarction patients alone.Compared with non-diabetic patients,the intestinal flora of diabetic patients changed significantly,and the expression of IL-6 increased,and it was positively correlated with the abundance of Bacteroides.Compared with patients without aspirin resistance,patients with aspirin resistance had significant changes in abundance of Clostridium and Ruminococcus,but there was no significant difference in the level of inflammation between the two groups.