| Objective: To investigate the correlation between aspirin resistance and COX-1 A842 G and COX-2 G765 C gene polymorphism in patients with ischemic stroke.Methods:1.Ninety-two patients with acute ischemic stroke who were admitted to the Department of Neurology of the First Affiliated Hospital of Hebei North University from February 2019 to February 2020 were selected.After admission,they were all given anti-platelet aggregation,plaque stabilization and other conventional treatment.2.In all patients with AIS,the total cholesterol,high density lipoprotein cholesterol and triglyceride fatty acid levels were recorded within 24 hours of admission TG),homocysteine homocysteine(HCY)and before taking aspirin treatment by the rate of the platelet aggregation induced by arachidonic acid(PAg-AA %)and aspirin treatment 10-14 days PAg-AA %,and using the PAg-AA % 20% or higher AS the standard for aspirin resistance,all the patients can be divided into aspirin resistance(aspirin to hold AR)group,aspirin sensitive(aspirin sensitive AS)group.The gender,age,history of hypertension,history of coronary heart disease,history of diabetes and the above test indexes were compared between the two groups to explore the clinical related factors of AR.3.The genetic polymorphisms of COX-1 A842 G and COX-2 G765 C were detected by DNA sequencing method,and the genotypic differences of A842 G and G765 C were compared between the two groups,and the correlation between gene polymorphisms and AR was discussed.4.All patients were instructed to continue taking aspirin regularly at100mg/ day after discharge,and patients with drug change and irregular oral aspirin were excluded.Patients with recurrence within one year were counted,and thus the patients were divided into the recurrence group and the non-recurrence group.The incidence of AR was compared between the two groups to explore the relationship between AR and AIS recurrence.Result:1.No mutant genotype was detected in COX-1 A842 G.Three genotypes,GG,GC and CC,were detected in COX-2 G765 C,among which CC and GC were variant genotypes.The genotype distribution frequency of COX-2 G765 C site in AR group was significantly different from that in AS group(P < 0.05).2.PAG-AA % in patients with COX-2 G765 C gene variation before and after aspirin administration was higher than that in patients without variation,the difference was statistically significant(P < 0.05).No matter which genotype,oral aspirin could reduce PAG-AA %,but the reduction range of normal genotype was larger than that of mutant genotype,and the difference was statistically significant(P < 0.05).3.There were no significant differences in gender,age,hypertension,coronary heart disease,TG,HDL-C,LDL-C and Hcy levels between AR and AS groups(P > 0.05).The levels of diabetes and CHOL in AR group were higher than those in AS group,and the difference was statistically significant(P < 0.05).Multivariate Logistic regression analysis showed that diabetes mellitus and high CHOL were related to AR(P <0.05).4.Compared with the incidence of AR in the recurrence group and the non-recurrence group,the incidence of AR in the recurrence group(44.44%)was higher than that in the non-recurrence group(21.25%),but the difference was not statistically significant(P > 0.05).Conclusion:1.The polymorphism of COX-2 G765 C gene is associated with AR and platelet aggregation rate in patients with ischemic stroke,and the mutant genotype has a low response to platelet inhibition.2.The COX-1 A842 G genotype of patients with ischemic stroke was only AA,and its polymorphism was rare.3.The occurrence of AR may be related to diabetes mellitus and high CHOL.4.The recurrence rate of cerebral infarction in patients with ischemic stroke and AR is high,which should be paid clinical attention. |
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